Business Before Questions

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Oral
Answers to
Questions

Transport

The Secretary of State was asked—

Great British Railways: National Headquarters

Matt Vickers: What progress he has made on establishing a national headquarters for Great British Railways.

Kevin Hollinrake: What steps he is taking to identify the most suitable location for the headquarters of Great British Railways.

Grant Shapps: May I start by saying that my thoughts are with those affected by the tragic incident in the river at Haverfordwest at the weekend, where three lives were lost? My thanks go to the emergency services. The Maritime Accident Investigation Branch is currently investigating. Similarly, my thoughts are with everyone affected by the rail incident that took place in Salisbury this weekend. I am grateful to the train crews and drivers, and the services that looked after those who were injured. Our thoughts go to the families of all those affected.
The Great British Railways transition team is designing a selection process for the headquarters and details will be announced shortly.

Matt Vickers: Stockton-on-Tees was home to the world’s first passenger railway. The discussion about building that railway was held in Stockton town hall. The first track of that railway was laid in Stockton. The  first ticket was sold in Stockton. Last week, Michael Portillo backed our bid. I understand that Thomas the Tank Engine and even the Fat Controller are on board. Can the Secretary of State think of anywhere better than Stockton to be the home of Great British Railways?

Grant Shapps: My hon. Friend makes an excellent case. I was not aware of the Fat Controller’s involvement, but that could well nail it. When the competition launches, everywhere with a strong railway connection will be able to apply, so we can find a new HQ for Great British Railways.

Kevin Hollinrake: Putting Stockton to one side, not only does York have a unique railway heritage, but it is home to 10% of the national railway workforce. It is a beautiful and wonderful city. Does my right hon. Friend agree it would make the perfect home for the headquarters of Great British Railways?

Grant Shapps: It is also the home of many beautiful trains of the past, including the Mallard, which I went to see very recently. My hon. Friend makes a very strong case. I can see that the whole House is looking forward to entering the competition to find the new HQ for Great British Railways.

Lindsay Hoyle: I am now tempted to call the hon. Member for York Central (Rachael Maskell), who will reinforce that point.

Rachael Maskell: But of course, Mr Speaker. York is not just about 200 years of the history of the railways; it is home to some of the leading rail engineers of the future and digital rail, as well as leadership from our operations and rail systems. This cannot just be about hotspots where people have their favoured city; it must also be about bringing the rail community together to ensure we make the most of the future for our rail systems. Will the Secretary of State look very closely at the bid from York?

Grant Shapps: The hon. Lady is absolutely right. I should point out that the competition has not been launched yet, but I am very impressed by the extent to which the whole House is in favour of their areas. York, of course, will have a very good bid. There is a serious point to this, which is that it is important we have the right HQ for Great British Railways, as we bring the entire network together. I am sure that York, as well as many other towns and cities, will have an excellent case to make.

Rail Investment in the North: Levelling Up

Imran Hussain: What recent assessment he has made of the potential effect of his policies on rail investment in the north of England on the Government’s levelling up agenda.

Andrew Stephenson: Investing £29 billion in transport across the north since 2010 has had a hugely positive impact on levelling up.

Imran Hussain: Building Northern Powerhouse Rail in full with a stop in Bradford city centre will help to transform Bradford’s economy and draw much-needed jobs and investment into the district, yet the Government are now believed to be scrapping the plans for NPR.  Will the Minister give me some certainty today and either commit to the plan, or admit that the reality is that the Government have no intention of delivering real, transformative change to the economy and lives of people in West Yorkshire?

Andrew Stephenson: The hon. Gentleman will know that I know Bradford well, as I represent a constituency just down the road, on the sunny side of the hills. The Government are committed to supporting the aspirations of local leaders across West Yorkshire. We recognise that Bradford is an important economic centre in the north, with a growing and young population. We continue to look at the evidence for building a new station in Bradford, and decisions, as he knows, will be outlined in the integrated rail plan in due course.

Tan Dhesi: My thoughts and prayers are with all those affected by the Salisbury train collision and I wish those who have sadly been injured a speedy recovery. We must, in the near future, get to the bottom of how such an incident could ever have occurred.
After the Budget, northern leaders were left even more bemused than before about Government plans for the north. There was no mention of Northern Powerhouse Rail and nothing more on HS2’s eastern leg or the midlands rail hub. There is still no rolling programme of electrification and no sign of the mythical integrated rail plan, which Ministers have kept referring me to for over a year. What a complete lack of ambition for the north. How did this happen? Was it because the Secretary of State could not convince the Chancellor to invest in our country’s railways, or was it because the Chancellor thought that giving tax cuts to already wealthy bankers was far more important?

Andrew Stephenson: Let us not pretend that we are not getting on with the job of investing in the north of England. We have invested £29 billion in northern transport since 2010, and in the Budget that the hon. Gentleman referred to, we announced over £1 billion for Greater Manchester, over £830 million for West Yorkshire and £570 million for South Yorkshire. I am delighted to say that the integrated rail plan is not just coming soon—it is now coming very soon.

Paul Howell: When it comes to investment in the north, I welcome the recent investments in the feasibility work for Ferryhill station and the Weardale line. Of course, I am disappointed with what happened regarding the knock-back for the Leamside line, but I ask the Minister to work with us and the hon. Member for Washington and Sunderland West (Mrs Hodgson) to look at funding streams and at potentially getting that into the integrated rail plan. Will he also assure the people of Ferryhill that knocking back the Leamside line does not in any way impact the Ferryhill project?

Andrew Stephenson: My hon. Friend continues to make a powerful case for his constituency and investment in local transport schemes. As he knows, I have family ties with Ferryhill—my father was born there—and I am very keen to support local people’s aspirations. I know that he has been lobbying the Secretary of State, the Rail Minister—my hon. Friend the Member for  Daventry (Chris Heaton-Harris)—and myself on this issue. We will continue to work with him to see what we can do to support local aspirations.

International Travel: Covid-19

James Sunderland: What steps his Department is taking to help make international travel (a) easier and (b) less expensive during the covid-19 pandemic.

Grant Shapps: Thanks to the successful vaccine roll-out, the Government have been able to open up international travel and help to make it cheaper to use, with 135 countries and territories now covered by our inbound vaccination policy.

James Sunderland: The aviation and travel sectors are pivotal for my constituents in Bracknell and right across the UK, sustaining many jobs and livelihoods. Will my right hon. Friend confirm what is being done to review testing requirements for passengers and travellers and to regulate the wildly varying and often exorbitant cost of testing?

Grant Shapps: As the House will know, we have reduced the number of tests required to just one single lateral flow test on day two for everybody who is vaccinated, as well as for under-18-year-olds. My hon. Friend will be interested to hear that I spoke to the Health Secretary this morning about the site that it runs to ensure that the prices shown there are accurate for the traveller, so that people can travel as normally as possible as we come to this Christmas and new-year period.

Roads

Mark Fletcher: What steps his Department is taking to improve the condition of roads in England.

Trudy Harrison: As announced in the spending review on 28 October, the Government are investing more than £5 billion over this Parliament in highways maintenance, enabling local highway authorities to fill in millions of potholes a year, repair bridges and help to resurface roads up and down the country. The spending review has also fundamentally protected the Government’s plans for RIS2, the second road investment strategy, while adjusting for schemes that are now progressing to a different timetable.

Mark Fletcher: More than 300 of my constituents have already signed my petition backing plans to improve junction 28 of the M1. It has been a constant bottleneck; residents of Pinxton and South Normanton are so often stuck there for a very long time. Will the Minister commit to working with me to make sure that we can deliver plans to improve that junction?

Trudy Harrison: Yes, of course. I congratulate my hon. Friend on his petition. I can reassure him that National Highways has now submitted information on the scheme to the evidence base that will help to inform  the next stage of road investments. Thanks to his effective lobbying for his constituents in Bolsover, I can confirm to the House that National Highways has commenced a further study to assess the long-term future of junction 28 of the M1 to consider how planned growth may affect current and proposed schemes.

Bus Services

Andrew Jones: What steps he is taking to improve local bus services.

Trudy Harrison: The Government will invest more than £3 billion in buses during this Parliament, including a new dedicated £1.2 billion fund for London-style bus transformation deals to improve infrastructure, fares and services.

Andrew Jones: Harrogate has electric buses already, and they are very popular for their ride quality and their environmental benefit. I am keen to see their benefits extended, particularly to Knaresborough, where we have two air quality management areas and the very high-volume No. 1 route. Will the Minister update the House on where we are with the ZEBRA—zero-emission bus regional areas—scheme?

Trudy Harrison: Absolutely. My hon. Friend is a superb champion for Harrogate and Knaresborough and has extensive experience of public transport. I am sure that he will appreciate the recent announcement of £355 million of new funding for zero-emission buses, which is in addition to the existing £120 million for the ZEBRA scheme. On ZEBRA, we also announced last week that almost £71 million of the funding has been awarded to Warrington, Leicester, Milton Keynes, Kent, Cambridge and Peterborough. We continue to work with a further 17 local transport authorities that will submit proposals. One of those areas is North Yorkshire; I understand that Harrogate and Knaresborough are part of the defined area. I look forward to working with my hon. Friend on the matter.

Lindsay Hoyle: I call the shadow Minister.

Sam Tarry: I welcome the Minister to Transport orals for what I believe is her first set of questions.
In April, I raised the devastating impact of Government cuts on rural transport networks, which has led to what CPRE calls “transport deserts”. I asked for
“assurances…that significant investment will be offered”
to support rural bus networks and
“ensure that our rural communities are genuinely connected”.
The Minister of State told me:
“There can be no greater champion of buses than the Prime Minister”.—[Official Report, 29 April 2021; Vol. 693, c. 501.]
He then gave assurances that funding was on its way.
Six months on, rural communities are still bearing the brunt of the Government’s failure to act. Many of the funding announcements in the Budget were nothing more than rehashed and repackaged initiatives that will do nothing to tackle the transport deserts that blight  the lives of ordinary people in so many rural communities, towns and villages. I ask again: will the Minister offer rural bus networks the tangible and significant investment that they so desperately need? Will she offer a firm deadline for when that will be done?

Trudy Harrison: As the hon. Member will know, in last week’s spending review, we set out an unprecedented level of support for buses, including zero-emission vehicles. This Government are supporting the bus network through manufacturing and through the infrastructure required as we decarbonise, as set out in our transport decarbon- isation plan.

Daniel Zeichner: Back in 2017, the hon. Member for Harrogate and Knaresborough (Andrew Jones) was the buses Minister. As he will remember, we had many discussions about the Bus Services Act 2017 and audiovisual announcements. Incredibly, some four and a half years on, the proposals for audiovisual announcements have still not been implemented. When can I expect to see and hear them on buses in Cambridge?

Trudy Harrison: We are working apace on this, and will be able to update the House in due course.

Several hon. Members: rose—

Lindsay Hoyle: We have a slight problem, in that the hon. Member for Broxtowe (Darren Henry) is trapped outside because Insulate Britain have blocked access to the House. That is totally unacceptable: it is interfering with democracy, and it is not what should happen. It is a tragedy that his constituents will not be represented by the hon. Member for Broxtowe, but I ask the Minister to answer the hon. Gentleman’s question.

Cycling and Walking

Darren Henry: What steps his Department is taking to encourage the uptake of cycling and walking.

Chris Heaton-Harris: It is slightly ironic, is it not, that the question is about cycling and walking, and how we can decarbonise transport. While I am sure that those people outside have decent intentions, the way in which they are going about their business is completely unacceptable.
We need to continue our business here, so I can happily update the House with the information that my Department is investing an unprecedented £2 billion in active travel over the course of this Parliament, which is the biggest ever boost for walking and cycling.
My hon. Friend the Member for Broxtowe (Darren Henry) would have asked a supplementary question, and I know that he wanted to talk about areas in his constituency, because that is all he ever does. [Laughter.] He wanted to talk about Mini-Hollands and how they can change people’s behaviour when it comes to cycling, and to mention the town of Stapleford. The Department’s publication “Gear Change”, which could be described as a manifesto for cycling, refers to Mini-Hollands. Expressions of interest have been received from more than 30 local authorities wishing to build them—including Nottinghamshire County Council—so they are clearly  remarkably popular. We are working on a list in order to progress to the next stage, and will receive a feasibility study in the next financial year.

Lindsay Hoyle: I now call the Scottish National party spokesperson, Ronnie Cowan.

Ronnie Cowan: Scotland’s active travel budget will soon amount to 10% of the transport budget, which means that at least £320 million a year—nearly £60 per person in Scotland—will be spent on walking and wheeling. The Department for Transport plans to spend less than £7 per head. When my hon. Friend the Member for Paisley and Renfrewshire North (Gavin Newlands) put that to the Secretary of State, he was disbelieving. Now that he has seen the proof, why is the Department short-changing active travel in England?

Chris Heaton-Harris: I am sure that the hon. Gentleman is very pleased about the amount of money that the Scottish Government are receiving for cycling and walking in a devolved settlement via the Barnett formula, but the figures that he has given are not correct. Spending on cycling and walking in England has doubled from a paltry £3.50 per head in 2010 to about £10 per head now, and obviously, given the massive increase in spending on cycling and walking—the largest that we have ever had in this Parliament, as a result of the Prime Minister’s “Gear Change” plans—that will continue to increase.

Robert Goodwill: Does the Minister, who is also the Rail Minister, agree that a key element of any cycling and walking plan should be better parking provision for cycles at railway stations?

Chris Heaton-Harris: I thank my right hon. Friend—a former Transport Minister—for his question. That is absolutely the case. One of the best gala dinners I have ever attended was the “cycle to rail” gala dinner, where awards were given for the best schemes of that kind. We are investing a huge amount of money in new, secure cycle parking around the country, and I went to see some of it not so long ago in the great city of Hull.

Glasgow Airport: Airspace Modernisation

Margaret Ferrier: What recent assessment he has made of the potential merits of the airspace modernisation proposals for Glasgow airport.

Robert Courts: Glasgow airport is engaged in the airspace modernisation programme, and is working with the Civil Aviation Authority and the Airspace Change Organising Group to develop its proposals.

Margaret Ferrier: With COP26 kicking off this week, the environmental impact of flying is at the forefront of many attenders’ minds. What assessment has the Minister made of the environmental benefits of potential airspace changes?

Robert Courts: UK airspace is among the most complex in the world, but it has not been modified significantly since the 1950s. Airspace modernisation will enable us  to have more direct, quicker, quieter and cleaner journeys, and will harness new technologies such as performance-based navigation. As set out in the “Jet Zero Consultation”, the Department’s analysis shows that
“Moving to best-in-class aircraft, operations and airspace modernisation could deliver 25-36% of CO² savings by 2050”,
bringing benefits not only for the hon. Lady’s constituents but for the whole United Kingdom.

Michael Fabricant: Is my hon. Friend aware that Rolls-Royce is now developing an aviation jet engine that will run on 100% sustainable fuel? When that happens, will it not show that flying can be not only fun but clean?

Robert Courts: My hon. Friend is absolutely right. I am aware of that engine that is being developed; in fact, I believe that my right hon. Friend the Secretary of State went to see it only this week. There are a number of exciting technologies with new aerospace advancements including sustainable aviation fuel that will deliver precisely the guilt-free flying that my hon. Friend refers to.

Mike Kane: We have an analogue airspace system in the digital age; the Minister is right in what he says. With the better ascents and descents of planes and the elimination of holding patterns, we will not only improve noise abatement but cut carbon emissions by up to 26%, as he rightly said. This is the lowest of the low-hanging fruit when it comes to the climate crisis, so can the Minister tell us what he is personally doing and how he is talking to the industry to unlock the funding we need to enable this programme to continue?

Robert Courts: The hon. Gentleman is quite right. There are a number of aspects to decarbonising aviation. There are the existing efficiencies as well as sustainable aviation fuel and the £180 million that we have recently announced on that. Then there is the longer-term but still rapidly advancing technology that was referred to earlier. He is also quite right to talk about airspace modernisation, and the Air Traffic Management and Unmanned Aircraft Act 2021, which was put through in the last Session, was a major part of that. It gives the Government extra powers. After the pause that took place during covid, we have given £5.5 million for the future airspace strategy programme, which is taking place as we speak.

Rail Services

Chris Green: What steps he is taking to improve rail services.

Chris Heaton-Harris: We are reforming rail guided by the “Great British Railways: Williams-Shapps plan for rail” White Paper. This will improve services for passengers and drive taxpayer value for money at the same time.

Chris Green: After many years of waiting, we have seen the electrification of the Manchester to Liverpool and Manchester to Preston railway lines. We are now looking forward to the electrification of the line between Bolton and Wigan. Can my hon. Friend confirm that this is going to go full steam ahead?

Lindsay Hoyle: No, we want electrification on that line!

Chris Heaton-Harris: Stepping back in time at the Dispatch Box, Mr Speaker. Steam is not necessarily an option for that particular line, but I am pleased to confirm that on 1 September this year, £78 million to electrify the route between Wigan North Western and Bolton was announced. It will enable greener electric trains—rather than Thomas the Tank Engine—to run along that route, with more seats to serve passengers across Greater Manchester. The scheme is on track and targeted for completion by 2024.

Wera Hobhouse: In Bath, we are still waiting for the full electrification of our lines, so perhaps the Minister will take that on board too. The direct line from Oldfield Park station in Bath to London Waterloo will be cancelled in December. Will the Minister reconsider these service cuts, which will make travel into south London nearly three times more expensive for my constituents and force them to use the underground while covid cases are rising?

Chris Heaton-Harris: On the hon. Lady’s last point, using the underground—and other trains—is one of the safest methods of transport in the covid pandemic. I believe that the air on the underground is exchanged every three minutes, and on trains every six minutes. They are perfectly safe. She referred to the consultation that has just finished on South Western Railway services, and she is quite correct: passenger numbers on that service are remarkably low. I will happily meet her to go through that, and we can talk about how we can improve those services.

Roadside Rescue and Recovery: Statutory Fees

Peter Aldous: What recent discussions he has had with the Home Secretary on ensuring that the statutory fees for roadside rescue and recovery are set and distributed in an equitable manner to ensure the long-term viability of that sector.

Trudy Harrison: The Home Office is currently considering responses to a targeted stakeholder consultation on the level of statutory fees for vehicle recovery.

Peter Aldous: I thank the Minister for that response. The fees paid to the often family-run businesses that provide this service have not risen since 2008, and there are cases of operators receiving less than 50% of the statutory fee. This is both unsustainable and unethical. Will my hon. Friend work with her counterparts in the Home Office to put in place arrangements that properly ensure the long-term viability of this industry, thereby keeping our roads safe?

Trudy Harrison: Absolutely. The Home Office is reviewing the responses to the consultation on the level of statutory fees for vehicle recovery. The purpose of the consultation is to gather evidence to ensure that fees are adequate to meet the current costs and operational needs of a sustainable vehicle recovery service. I welcome my hon. Friend’s keen interest in this area, and I will work alongside our colleagues in the Home Office as we progress this necessary update.

Rhondda Tunnel

Chris Bryant: What plans he has to visit the Rhondda tunnel.

Grant Shapps: As I said at the last Transport orals, I would be happy to visit when time allows.

Chris Bryant: I hope it will be very soon because, frankly, the harness is ready. The mines rescue service is ready to dangle the Secretary of State down a hole, and I will be right behind him.
On a serious point, the Rhondda railway tunnel is a disused tunnel that is 3,443 yards long. It belongs, oddly, to Highways England, so it is the Secretary of State’s responsibility. If we are able to reopen it as a cycle path, as many people hope, it would be the longest cycle path in Europe. It would be a major local attraction, which would be good for tourism and jobs in an area of outstanding beauty that unfortunately has terrible financial deprivation. The Secretary of State is welcome.

Grant Shapps: I did a bit of research following our last exchange at the Dispatch Box, and it transpires that National Highways owns the tunnel at the moment. I would be happy to transfer it to a local group, the Welsh Government or the local council, with money for the purpose. The hon. Gentleman is welcome to take that up, and I look forward to taking up his offer of a harness at some time in the future when I can see it fully open.

UK Transport Network: Decarbonisation

Stephen Hammond: What steps his Department is taking to decarbonise the UK’s transport network.

Grant Shapps: Our world-leading transport decarbonisation plan sets out how transport will be cleaner and greener, leading to healthier communities and supporting tens of thousands of jobs.

Stephen Hammond: I refer the House to my entry in the Register of Members’ Financial Interests.
It is a world-leading plan, and there is so much going on in the rail industry. As the Secretary of State well knows, cars are still the biggest emitter and the biggest contributor to air pollution. The key is switching to electric vehicles and hybrids. What is his Department doing to encourage local authorities to put up more charging points so the inflection point can happen sooner?

Grant Shapps: My hon. Friend is right. As the House is bored of hearing, I have been driving an electric car for the past two and a half years, and they are fantastic. People need to be convinced that they will be able to fill up and add energy when required, which is why we have put £2.5 billion into the process not just for grants for those cars but for the infrastructure itself.
My hon. Friend will be interested to hear that yesterday I was looking at a new design that will be unveiled at COP26 next week for an iconic electric charger that I  hope will one day be as familiar as the black taxi, the red phone box and many other iconic street items in order to encourage that move.

Kerry McCarthy: With COP under way, the Government should be sending the strongest signals on transport decarbonisation. On the one hand we have the chief scientific adviser telling people to fly less, as did a report from the nudge unit that the Government quickly deleted and suppressed, but on the other hand the Chancellor is cutting air passenger duty on domestic flights and the Prime Minister flew back from COP on a private jet for a supposedly urgent appointment that turned out to be a dinner for Telegraph journalists. Does the Secretary of State agree with the chief scientific adviser, or does he agree with the Chancellor and the Prime Minister? He cannot do both.

Grant Shapps: I will tell the hon. Lady who I do agree with: the Climate Change Committee. She may not be familiar with this, but it has said that its “overall assessment” is that our net zero strategy, launched this week at COP26, is “ambitious and comprehensive”. On the transport element specifically, the CCC says that it is very positive, rating our plans for transport decarbonisation as the highest in terms of planning; ours is the only sector with good plans and the funding, with incentives. So I hope she will accept that when it comes to transport we are doing everything we can.

Ronnie Cowan: The net zero strategy and the transport decarbonisation plan are full of climate buzzwords but are not backed up by the required investment. We have already heard about the paucity of active travel funding in England, but let us look at another area—buses. The Prime Minister boasted about his 4,000 green bus pledge, but that represents just 10% of the English bus fleet, whereas the Scottish Government have committed to helping fund 50% of our fleet—the equivalent of 20,000 buses. When will this Government’s ambition and investment match their rhetoric?

Grant Shapps: The hon. Gentleman points out the wonders of the Barnett formula, which allows our record-breaking funding of electric buses, which the Prime Minister has led, to be carried over into Scotland, where that money is able to be used in a way that is helpful. This does not get around the fact that, as we all remember, the Scottish Government have failed to meet their own carbon reduction targets. So I suggest he looks closer to home before criticising the enormous amounts of money coming through the Barnett formula.

Lindsay Hoyle: We now come to Question 13, and, once again, the Member of Parliament cannot access the House to represent democracy and his constituents. Once again, these people are blocking democracy, and the fact that Members who are actually trying to talk about these issues are being blocked from doing so is totally counterproductive. So what I would expect is for the Minister to answer Question 13, please.

Heathrow Airport Third Runway: Carbon Cost

Adam Afriyie: Whether he has plans to re-evaluate the carbon cost of a third runway at Heathrow Airport.

Robert Courts: I agree entirely with you, Mr Speaker, and observe that it is not only ironic, but totally counterproductive that a Member of Parliament who wished to ask Ministers about carbon is prevented from doing so by protesters purporting to care about carbon. I will do my best to answer my hon. Friend’s question, anticipating what he might have asked. I anticipate that he would have asked me, on behalf of his constituents in Windsor, about Heathrow expansion. He would have expanded on the carbon cost of a third runway, which is what is set out on the Order Paper. Of course, Heathrow expansion is a private sector project, which will need to meet strict criteria on air quality, noise and climate change. He is right to raise those questions. Clearly, the aviation sector has a big part to play in delivering the UK’s net zero commitment. Were he here, I would hope to be able to reassure him that we are continuing, through technology and aviation, to look for ways to reduce the carbon footprint of aviation, to ensure that we can transition to guilt-free flying. We will be setting out the final jet zero strategy early next year, which will show how we can support the benefits of air travel and the opportunities that aviation decarbonisation can bring to the UK. I say to the whole House and to everyone who is concerned about this issue that it is emissions, not flying, that is the problem.

Heavy Goods Vehicle Driver Shortages

Emma Lewell-Buck: What recent discussions he has had with Cabinet colleagues on the ongoing shortage of heavy goods vehicle drivers.

Grant Shapps: I regularly meet my ministerial colleagues, and together we have implemented 28 measures to alleviate the HGV driver shortage. So far, these measures are resulting in an extra 1,000 applications every week.

Emma Lewell-Buck: The Prime Minister was warned of this crisis way back in June, but it took until last month for there to be a paltry offer of 5,000 temporary visas, to fill 100,000 vacancies. The Government recently told the Select Committee on Transport that this crisis was going to last until the end of 2022—that is more than one whole year of empty shelves, port backlogs and rising prices. This is unacceptable incompetence. What is the Government’s plan to end this now?

Grant Shapps: First, it is important to set this in context. This is a global issue. I met my German counterpart here in Parliament just yesterday and it is estimated that by 2027 Germany will have a shortage of 185,000 HGV drivers. We have been taking action, and not just in the past few weeks, as the hon. Lady suggests; since I became Secretary of State, I have launched 28 measures, which are having a real impact. I mentioned that 1,000 more people are becoming lorry drivers each week—or, rather, are having their applications for a provisional signed through. We have actually got 1,000 a day applying for those forms, so we are starting to see those numbers come through. The Opposition leader tells us what his solution is, which is to issue 100,000 visas, which would completely undercut our own lorry drivers and take us back to square one.

East Birmingham Tram Line

Liam Byrne: What steps he is taking to support investment in the East Birmingham tram line.

Andrew Stephenson: Thanks to our hard-working Mayor, Andy Street, diggers are in the ground for the very first part of the East Birmingham tram line, to Digbeth from the city centre. We just awarded, in the spending review, over £1 billion to the West Midlands for transformative projects such as this, and I am sure the right hon. Gentleman will give all his support to our Mayor in the delivery of this important levelling-up priority.

Liam Byrne: Last week’s Budget was a step forward, but if we strip out the re-announced money, we see that it was actually £1 billion less than the Mayor asked for. That shortfall jeopardises our potential to build the 8-mile tram line through east Birmingham, so will the Minister meet me and other Members from east Birmingham so that we can explain to him the cross-party ambition to build the line? We cannot connect what are the poorest communities in the country with the wealth created by High Speed 2 without the tram line, and we cannot level up what is, in effect, the fifth-biggest city in Britain without it.

Andrew Stephenson: The Minister responsible for trams, my hon. Friend Baroness Vere, would be happy to meet the right hon. Gentleman to discuss that and other local priorities. He will be aware that the £1 billion announced in the spending review is only one part of the transport investment that is going into the region. I hope that more good news will be announced for the West Midlands as part of the upcoming integrated rail plan.

Topical Questions

Clive Betts: If he will make a statement on his departmental responsibilities.

Grant Shapps: Mr Speaker, you have rightly highlighted the Insulate Britain protests outside the House that are preventing Members from getting into the Chamber, which is completely unacceptable. I therefore thought it would be helpful to update the House: following my requirement that National Highways seek injunctions against the protesters, 475 injunctions have been served to protesters at their homes for contempt of court, of which 32 are due to come to court, nine of them later this month.
When it gets to the point that protests against climate change prevent Members of this House from getting here to hold Ministers to account and be heard, it is clearly counterproductive. Contempt of court can lead to unlimited fines and prison sentences. We will act through the Police, Crime, Sentencing and Courts Bill to resolve the gap in the law that has led to this situation.

Clive Betts: Five years ago, Sheffield looked as though it was going to benefit from a whole range of levelling-up measures for rail infrastructure, but then the electrification of the midland main line was abandoned in 2017; a positive 2016 report on a new road tunnel between  Sheffield and Manchester seems to have lain in the bottom of some ministerial drawer since; and the high-speed rail line between Sheffield and Manchester seems to have become an upgrade to the Hope Valley line which, however welcome, means that trains will get to the very high speed of under 60 mph. The one thing we have left is the eastern leg of High Speed 2. Will the Secretary of State now commit to that eastern leg going ahead? Or is this simply another example of Sheffield being not levelled up but, together with whole parts of the east midlands, being forgotten about and left behind?

Grant Shapps: I am disappointed by the hon. Gentleman’s lack of ambition. He says that only the east midlands line is left; he is wrong: there are still other upgrades to be considered, such as the midland main line and many others. I am afraid he will have to wait for the integrated rail plan, but I think he will be excited when it is delivered.

Felicity Buchan: The Mayor of London is making cuts to seven bus routes in my constituency and has halted the upgrade to South Kensington tube station, at the same time as he has increased the congestion charge to £15 a day for my constituents. Does my right hon. Friend agree that this reeks of financial incompetence on the part of the Mayor and Transport for London?

Lindsay Hoyle: I think you might get a favourable answer here.

Grant Shapps: You will not be surprised, Mr Speaker, to hear me say that my hon. Friend is absolutely on the nail. She has listed a litany of problems that the Mayor has created; I shall add to it. She did not mention the 31% increase in council tax for her constituents through the mayoral precept. Also, the Mayor is now considering bringing in checkpoints for anybody driving into London: it would cost £1,000 a year for non-Londoners at checkpoint Chigwell and elsewhere around the capital. It is completely unacceptable and we will fight it all the way.

Jim McMahon: May I begin by sending my thoughts and prayers to those injured in Sunday’s train crash, particularly the badly injured train driver, and, of course, I pay tribute to the emergency responders.
The British people are looking for leadership on climate change. The Budget was the clearest indication yet that the Government lack ambition, urgency and commitment after a wearying 11 years in power. The Government saw cuts to domestic aviation taxes, yet baked in inflation-busting rail fare increases and did nothing to reverse the rapid decline in bus use. Of the 4,000 new zero-carbon buses promised by the Prime Minister two years ago, not a single one is yet on the road. The roll-out of electric charging points is sluggish, and, today, there are 1 million more diesel vans on the road than when the Government came to power. So, next week, when Transport Day meets at COP26, what will change?

Grant Shapps: I note that the hon. Gentleman is not listening to the Committee on Climate Change. I will not repeat its quote, but it did say that the transport sector and our plans are particularly world leading. We  have actually reduced greenhouse gas by a quarter since we came to power. We are the first country in the world, as he well knows, to legislate for net zero by 2050. In the Budget, we announced another £620 million for that transition to zero-emission vehicles and £180 million for sustainable aviation fuel. The plan that Labour is proposing—and I notice that the GMB union that supports it is proposing—is to stop people from flying, or to allow them to go on holiday only once every five years, and to prevent them from using their cars.[Official Report, 16 November 2021, Vol. 703, c. 4MC.]

Jim McMahon: With respect, our position on aviation and decarbonisation is absolutely clear. I want to stop the Transport Secretary not from flying, but perhaps from flying his own private plane.
Turning to smart motorways, it has been 10 months since I asked the Secretary of State to reinstate the hard shoulder immediately. No action followed. Instead, he ploughed ahead on smart motorway roll-out. Since then, whistleblowers have come forward confirming our worst fears: broken equipment; a lack of monitoring; and, ultimately, lives being placed at risk. This failure has had a devastating impact on people’s lives. Now that the Transport Committee has published its damning report and the families of those who lost loved ones on smart motorways were forced into Parliament Square this week to protest, will he do the right thing and immediately insist that the hard shoulder is reinstated today?

Grant Shapps: We all share the passion and desire to make sure that our roads are as safe as they can possibly be. Sadly, 1,700 people die a year on our roads. It is important that we do everything possible. The Transport Committee that the hon. Gentleman quotes did not say quite what he said. It actually said:
“The evidence suggests that doing so”—
in other words simply putting the hard shoulder back in—
“could put more drivers and passengers at risk of death and serious injury.”
It was the noble Lord Prescott who started to introduce smart motorways. As far as I am aware, I am the first Secretary of State—there have been 12 since—who has been working consistently with an 18-point plan and £500 million to get them sorted out.

James Sunderland: I am aware that the Government are about to legislate on vehicle modifications for reasons of road safety. Can the Minister please reassure me that this will not unduly affect our legitimate engine tuning activities, our buoyant classic and prestige car markets and also our world-leading motor sports industries, all of which are pivotal for sustaining many thousands of jobs.

Trudy Harrison: I can assure my hon. Friend that our intention for this consultation is to prevent modifications that negatively impact on road safety, vehicle security and the environment. Department for Transport officials have been instructed to ensure that proposals do not prevent activities such as restoration, repairs or legitimate improvements to classic cars, or do any damage to the motor sports businesses involved in these activities. Motor sport is an important sector for society, our  economy and our heritage and I thank my hon. Friend for all that he does in championing this important area, as he is a fantastic advocate.

Alex Cunningham: Rail services on, to, and from Teesside are probably some of the worst in the country, with hand-me-down diesel trains and intermittent services. Soon we will have the 200th anniversary of the start of the railways, which was the Stockton and Darlington railway. Any chance of improvements before then?

Chris Heaton-Harris: There are a whole host of massive improvements going on across our railways. I will happily meet the hon. Gentleman to talk about individual diesel multiple units around the Stockton area and how they can be improved. The massive increase in new rolling stock on our railways is extraordinarily good for all passengers up and down the country, and helps with our decarbonisation targets.

Robert Goodwill: I very much welcome the Minister’s answer to my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones), outlining the good news in the Budget on the delivery of more buses towards our target of 4,000 zero-emission buses. There are three manufacturers here in the UK that can deliver these buses, including one with a production line in Scarborough. Will the Minister give me a guarantee that these orders will be placed with UK manufacturers?

Trudy Harrison: As Scarborough and Whitby is the proud home of Alexander Dennis coaches, I know that my right hon. Friend will welcome the firm acceleration that is supporting thousands of zero-emission buses, thanks to a further £355 million of funding announced in the spending review last week. With £71 million extra for our zero-emission bus regional areas scheme, we are bussing back better with a cleaner, greener kind of horsepower.

Judith Cummins: One of the largest city-to-city journeys to work in the country is between Bradford and Leeds, and those journeys are mostly by car. At scale, Northern Powerhouse Rail would support a 400% increase in rail travel and take 64,000 car trips a day off the roads. With COP under way, do this Government have a strategy to ensure that our covid recovery is by rail, rather than by road, and will that include—because it should—Northern Powerhouse Rail in full, with a city centre stop in Bradford?

Andrew Stephenson: The hon. Lady tempts me to speculate on the contents of the integrated rail plan. As I said in response to the hon. Member for Bradford East (Imran Hussain), she will have to wait and see. However, the Government recognise the importance of Bradford, and particularly the connectivity of Bradford to Leeds—two incredibly important northern cities. I hope that we will publish the integrated rail plan very soon.

Michael Fabricant: The Birmingham cross-city line is, I am told, the second busiest rail line in the whole United Kingdom. A continuation of it is the route from Lichfield to Burton  via the National Memorial Arboretum. At present, that line is only used for freight traffic. Will my right hon. Friend the Secretary of State visit—without a harness—so that he can have a look at the rail line for himself and see what a valuable addition it would be to the rail network?

Lindsay Hoyle: The Fabricant line.

Michael Fabricant: Yes, I’d like that.

Chris Heaton-Harris: I would be delighted to visit. I am sure that the Secretary of State would as well; he definitely does not need a harness to visit places. We are well aware of the opportunities that exist in this area and the importance of the National Memorial Arboretum to so many people. I look forward to continuing conversations with my hon. Friend in due course.

Christine Jardine: My inbox—and, I am sure, those of many other Members—is mounting up with complaints from constituents who have been waiting months for responses from the Driver and Vehicle Licensing Agency about drivers’ applications. Many of them are professional drivers, of whom there is a shortage at the moment. One of my constituents who was renewing his licence has not had a reply in time and now cannot work. Will the Secretary of State assure us that something is being done to catch up with the backlog?

Grant Shapps: I bring the hon. Lady and the House good news. It was reported a few weeks ago that there were 56,000 outstanding licence applications at the DVLA, where there had been a long-running strike during covid. The good news is that that 56,000 is now down to just 16,000, of which 4,000 are returned within five days. Those are the new applications. The remainder are being worked on quickly and do not, in fact, stop anybody from driving. They are largely renewals, changes of address and so on. Drivers are allowed to continue driving while waiting for those to be returned, but we will have even that list down within the next week or two.

Lindsay Hoyle: I call Darren Henry.

Darren Henry: Thank you, Mr Speaker. I do appreciate your understanding when I was blocked getting into the House earlier today by the protesters.
Last year, thankfully, the Prime Minister came to Broxtowe to announce “Gear Change”, which provides £2 billion-worth of cycling and walking funding. That indicates that active travel is really at the heart of the Government’s agenda. I have in Broxtowe a town called Stapleford where people have put in an expression of interest for something called Mini Holland, which sounds fantastic. Will the Minister explain what that scheme is all about and how the process will work?

Lindsay Hoyle: He already has, but don’t worry.

Chris Heaton-Harris: I will try to amend my answer from earlier. I am very pleased to see my hon. Friend in his place, as he should be, representing his constituents despite the Tarquins in the world outside. I can honestly say to him that “Gear Change” is an extremely important document that has a whole host of pledges that we would like to happen, Mini Hollands being one of  them. Where they have been introduced before—Waltham Forest in London is a good example—we are getting towards nearly 50% of all journeys taken within the area being by active travel. That is a massive change in how people go about their business, and indeed massive acceptance by communities that might have been sceptical about them beforehand. They are really valuable schemes.

Chi Onwurah: The Secretary of State and the Chancellor press-released that the Budget would invest in northern transport, but once again the north-east was entirely overlooked. It costs more for a Geordie to go four stops up the West Road on a bus than it does for a Londoner to traverse the whole of London city, so when will the Secretary of State level down bus prices?

Grant Shapps: The hon. Lady will be familiar with our enthusiasm for buses and the “Bus Back Better” strategy. I have personally been involved with putting tens of millions of pounds into the excellent Nexus system, which helps to connect communities as well. She will simply not find a Government more keen and excited about levelling up transport and bringing it all the way up the country no matter where hon. Members are from.

Lindsay Hoyle: I call Adam Afriyie.

Adam Afriyie: Thank you, Mr Speaker. It is very seldom that I become furious, but I am absolutely apoplectic about missing my question this morning due to those reprobates outside who are doing their cause no good whatsoever. I was sitting in my electric vehicle—I know the Secretary of State has one as well—coming here with the sole purpose of putting pressure on the Government to reduce carbon emissions from aviation from Heathrow airport, so it is absolutely bizarre that they should have blocked that question. My question now, which I will slightly rephrase, is: given that aviation is one of the greatest contributors to CO2 emissions, do the Government have any plans to continue to put downward pressure on CO2 from aviation?

Robert Courts: I am very glad to see my hon. Friend here fighting for his constituents, as ever. I am glad that he made it in past the protestors to make that entirely forceful and appropriate point on their behalf. He is right to acknowledge that aviation is one of the harder to decarbonise sectors, and clearly it has to make a big contribution. The Government are working very hard to make sure that the carbon emissions in aviation are reduced, through technology and innovation, because we wish to see guilt-free flying. We have consulted on the “Jet Zero” strategy. Next year we will publish the final “Jet Zero” strategy, which will explain how we can keep the benefits of air travel and the opportunities that it has for the UK while ensuring that it is done on a vastly reduced carbon emission basis.

Rachael Maskell: Since City of York Council barred blue badge holders from accessing our city centre, it seems also that the Government are delaying implementing fully accessible transport. We heard earlier about the five-year delay on audio-visual for buses, but also, in commissioning active travel schemes,  the Government are not making them accessible either. Will the Minister talk to the companies that are putting in place e-travel active travel schemes to ensure that they have an accessible form of vehicles as well so that we can increase motability for disabled people?

Chris Heaton-Harris: I thank the hon. Lady for her question. I think I completely understood it, but in case I have not, perhaps it is worth us meeting to clarify this. Yes, we are spending a huge amount on active travel. Another pledge in “Gear Change” is to have e-bikes going out across local communities, and they are being rolled out now, as they should be. This is determined by local authorities, and perhaps it is a question of localism, but let me meet her to work out what the problem is and rectify it, because we should be able to give it a good nudge from the centre.

Lindsay Hoyle: I call the voice of the Potteries, Jonathan Gullis.

Jonathan Gullis: There can be no better place to Bus Back Better than the great city of Stoke-on-Trent, because, sadly, in a survey of 230 residents from across Stoke-on-Trent North, Kidsgrove and Talke, people said to me that fares are not fair, reliability is non-existent and there is not good connectivity for places such as Brindley Ford and the great village of Milton. The Secretary of State joked with me recently that I must have broken WhatsApp, because I kept bombarding him with demands and messages. He should save himself a load of hassle, give Stoke-on-Trent the  £90 million it wants for the Bus Back Better strategy, and ensure that we level up in the great city of Stoke-on-Trent.

Lindsay Hoyle: A straight yes, Minister?

Trudy Harrison: Absolutely yes, Mr Speaker. I thank my hon. Friend for his championing of Bus Back Better. The Government are absolutely determined that great bus services be available to everyone, especially those in Stoke-on-Trent. Our national bus strategy explains how we will make buses more frequent, more reliable, easier to understand and use, better co-ordinated and cheaper. We are more than doubling dedicated bus funding compared with the previous Parliament.

Wera Hobhouse: Making aviation net zero is clearly a big challenge. Earlier, the Secretary of State said that it is not flying that is the problem, but emissions from aircraft that use fossil fuels. Will he meet me to discuss ideas around synthetic fuels that scientists from the University of Leeds have brought to my attention?

Robert Courts: I would be delighted to.

Peter Aldous: The new agreement between the Department for Transport and Greater Anglia on running the railways in East Anglia has omitted the previous commitment in the franchise to reinstate through-services from Lowestoft to Liverpool Street. Greater Anglia has agreed that it will look at that over the next six months. Will my hon. Friend work with it and me to see whether it is possible to do that?

Chris Heaton-Harris: Yes.

Business of the House

Thangam Debbonaire: Will the Leader of the House give us the forthcoming business?

Jacob Rees-Mogg: Before I begin, I congratulate you, Mr Speaker, on this day of legend and song, because it is the second anniversary of your being dragged to the Chair with notable reluctance. The business for next week is as follows:
Monday 8 November—Consideration of Lords message relating to the Environment Bill, followed by consideration of Lords amendments to the Telecommunications (Security) Bill, followed by Opposition day (7th allotted day—second part). There will be a debate on a motion in the name of the official Opposition. Subject to be announced, followed by motion to approve the draft Motor Vehicles (Driving Licences) (Amendment) (No. 2) Regulations 2021 and the draft Motor Vehicles (Driving Licences) (Amendment) (No. 4) Regulations 2021.
Tuesday 9 November—General debate on giving every baby the best start in life, followed by general debate on the provision of school-based counselling services. The subjects for these debates were determined by the Backbench Business Committee.
At the conclusion of business on Tuesday 9 November, the House will rise for the November recess and return on Monday 15 November.
The business for the week commencing 15 November will include:
Monday 15 November—Consideration of Lords amendments to the Social Security (Up-Rating of Benefits) Bill, followed by Second Reading of the Skills and Post-16 Education Bill [Lords].
Tuesday 16 November—Second Reading of the Finance (No. 2) Bill.
Wednesday 17 November—Opposition day (8th allotted day). There will be a debate on a motion in the name of the official Opposition. Subject to be announced.
Thursday 18 November—Consideration of a business of the House motion, followed by all stages of the Critical Benchmarks (References and Administrators' Liability) Bill [Lords].
Friday 19 November—Private Members’ Bills.
The provisional business for the week commencing 22 November will include:
Monday 22 November—Remaining Stages of the Health and Care Bill (Day 1).
Tuesday 23 November—Remaining Stages of the Health and Care Bill (Day 2).
I would like to mark the retirement of Crispin Poyser, who has served the House as a Clerk for more than 40 years. A good understanding of “Erskine May” is essential for the functioning of Parliament, and Crispin is a great proceduralist. In the House and in his secondment to the Cabinet Office as parliamentary adviser to the Government, his work has underpinned the principle of accountability to Parliament. We should all be grateful. I know that his colleagues will miss his expertise nearly as much as they will miss him. I thank him for his terrific public service.
I am aware that last night’s vote has created a certain amount of controversy. It is important that standards in this House are done on a cross-party basis. The House voted very clearly yesterday to show that it is worried about the process of handling complaints, and that we would like an appeals system; but the change would need to be supported on a cross-party basis, and that is clearly not the case.
While there is a very strong feeling on both sides of the House that there is a need for an appeals process, there is equally a strong feeling that this should not be based on a single case, or applied retrospectively. I fear last night’s debate conflated the individual case with the general concern. This link needs to be broken. Therefore, I and others will look to work on a cross-party basis to achieve improvements in our system for future cases. We will bring forward more detailed proposals once there have been cross-party discussions.

Lindsay Hoyle: I would also like to express the thanks of the whole House to Crispin Poyser for his 43 years of service to the House. We wish him and his wife Krissie well, and send our best wishes for the many things that they will do next. Crispin is known among colleagues for his keen procedural mind, curiosity and kindness. He will be missed by the House, and I thank him for the loyal service that he has given.

Thangam Debbonaire: I thank the Leader of the House for the forthcoming business. I join him and you, Mr Speaker, in paying tribute to Crispin Poyser. Clerks are some of the many unsung heroes who keep this place going. We are incredibly grateful to them all; they appear to know absolutely everything. I wish Crispin Poyser a happy retirement from this place. I also wish everyone a happy Diwali. May light shine on us all.
I am frankly astonished by what the right hon. Gentleman just said about separating the review of the standards process from the individual case. Government Members made the choice yesterday to link the two. There is no separating them retrospectively—he has made much of the fact that the Government do not want retrospective rule change. Much was said about the standards procedure not being in line with that in other workplaces, but MPs are holders of public office, not employees. We are subject to professional self-regulation, not employment law.
Government Members cannot pick and choose; if they want to be treated as employees of this House, rather than office holders, then alongside all other employees, they should be wearing masks around the estate and in the Chamber. Unfortunately, unlike when it comes to breaking the rules about paid advocacy, a convivial and fraternal spirit does not protect everyone else. The Government cannot have it both ways. Can the right hon. Gentleman ask his friends to do the right thing and wear their masks—if not for themselves and each other, at least for the staff?
On Monday, the Committee on Standards in Public Life published its 23rd report. More than 25 years have passed since the seven principles of public life were first introduced off the back of a previous escapade of Tory sleaze and corruption, and we and the Government are back there again. Can the Leader of the House confirm whether the Government will endorse the report? Or, if they do not like the recommendations, which I strongly suspect that they do not, will they just  abolish the committee? Will they establish another sham Committee, so that the Government can get the answers they want?
Labour will not participate in the sham Committee that the Tories voted through yesterday, despite what the right hon. Gentleman has just said. We will look with interest at his proposals, but we will not participate in a parallel process when the Chair of the Committee on Standards, my hon. Friend the Member for Rhondda (Chris Bryant), who is sitting behind me, is doing such a great job with the other cross-party members of the Committee and its lay members.
How will the other Committee be resourced? Has there been a proposal under the estimates process? Considering that the Committee will risk wasting taxpayer’s money, which I know the Leader of the House dislikes intensely, if he cannot get it past estimates, could he ask one of his hon. Friends to contribute some of their lobbying money? Or will he perhaps pay the Chair’s salary?
As the Opposition will not participate in the sham Committee, will the Leader of the House confirm whether it will sit with only Tory members? How will it be decided who sits on the Committee, whether it is the one voted through yesterday or the other one that he has mentioned this morning?
Given the Business Secretary’s frankly disgraceful comments this morning, can I ask whether the Leader of the House agrees with him that the Parliamentary Commissioner for Standards, who was properly appointed, should resign? Is that his view—yes or no?
To continue on the theme of standards, I asked the Leader of the House last week about the updated ministerial code. As I said then, six months have gone by since Lord Geidt was appointed as the new independent adviser, but we still do not have that code. The Government seem to think it is okay for MPs to act as paid advocates for private companies, so it is no surprise to me that they do not seem to have much regard to it. Will the Leader of the House please confirm when it will be published, or whether they are just going to get rid of that as well?
This month is Islamophobia Awareness Month. Earlier in the week, my hon. Friend the Member for Manchester, Gorton (Afzal Khan) said that this time a year ago, he wrote to the Prime Minister raising concerns over Islamophobia, and a year on, the Prime Minister has still not responded to my hon. Friend. This is wholly unacceptable. Can the Leader of the House please ask the Prime Minister when he will write back to my hon. Friend? Can he also again remind his other Cabinet colleagues of their responsibilities to this House, because I am afraid that we are still not getting timely—or indeed in some cases any—answers to written parliamentary questions or letters, or from hotlines?
Finally, to avoid any unfortunate coincidences, as Conservative Members have put it, between current cases and other Committees or processes, will the Leader of the House take this opportunity to say whether there are any other parliamentary procedures or Committees that he is likely to want to amend, abolish or duplicate—or will he wait until another one of his friends needs saving?

Jacob Rees-Mogg: May I join the hon. Lady in wishing people a happy Diwali? I hope that they enjoy their celebrations.
There is a problem with people writing their questions before they have heard what has been said, because I made it quite clear in my business statement that we need to proceed on a cross-party basis, and it is a matter of regret that there was no cross-party agreement yesterday. Obviously, a Committee cannot work effectively without Opposition Members on it, and I think that was absolutely clear from what I said.
We need to ensure that we have standards in this place that are fair and robust, and that are seen to be fair and robust. I would highlight the Independent Complaints and Grievance Scheme, which has an appeal body, the independent expert panel. The independent expert panel has on it a High Court judge—somebody of the highest standing and legal training—but that is not the case for standards cases. This issue has been bubbling away for some time, as people have seen the differential between the two.
Of course, I listened very carefully to the debate yesterday, and to comments made from across the House, and I absolutely recognise that it is important to proceed on a cross-party basis to have the highest standards in this House, but ones that, when implemented, are fair to those they are applied to. That is what we will seek to achieve. I hope that the hon. Lady and others are willing to enter into this in a spirit of co-operation, as we did when we co-operated successfully with her predecessors over the ICGS question, to ensure that the ICGS could be taken out of the Standards Committee while remaining under its umbrella, and become a much more independent process.
I am grateful to the hon. Lady for raising the fact that this is Islamophobia Awareness Month, and for asking for a reply to a letter that has been sent. As I have said many times in this House, I view it as my role to facilitate for this House answers to legitimate questions. This is a matter of priority for me, and I regularly remind my hon. and right hon. Friends of the need to respond. I will continue to do that, and I can assure her that I will take up with No. 10 Downing Street the letter that was sent last year.
On the hon. Lady’s question about whether there are any other planned changes, I am always rather with Palmerston: “Change, change—aren’t things bad enough already?”. However, I point out that the Procedure Committee is available to consider alterations to our procedures. It does invaluable work, and at the moment it is considering whether proxy voting should be extended.
The hon. Lady, and all other Members of the House, will know that our proceedings and processes have evolved. There was a lot of talk yesterday about 1695. As I am sure you are aware, Mr Speaker, that related to a Speaker, Sir John Trevor, who was given 1,000 guineas, I believe by the City of London Corporation and the East India Company, to influence proceedings in Parliament. He was therefore removed as Speaker, but rather oddly remained Master of the Rolls. We are so lucky, on your second anniversary, that no such question should arise with the current Speaker, who is fortunately not Master of the Rolls.

Andrew Jones: On Monday I attended a debate in Westminster Hall on research into endometriosis and polycystic ovary syndrome.  I was hoping, indeed planning, to participate, but such were the excellent speeches from female colleagues who had been suffering from that condition, as well as time pressures, that it was clearly appropriate to hear their important words first. The debate highlighted that it can take up to eight years between someone presenting and their diagnosis. Could we perhaps build on Monday’s debate, broadening the subject to consider how long it takes between presenting and diagnosis for someone with certain conditions, and what we can do to improve that?

Jacob Rees-Mogg: I am grateful to my hon. Friend for raising that important issue, which has also been raised with me by constituents. That is the sort of question that may well have come from Sir David Amess in the past, because he was a passionate campaigner for those suffering with endometriosis. The National Institute for Health and Care Excellence publishes authoritative evidence-based guidelines for healthcare professionals that help to ensure that the diagnosis, care and treatment of NHS patients is based on the best available evidence. I hope that eight years is not seen as an acceptable length of time for people to wait for diagnosis and treatment. In the spending review an extra £5.9 billion of taxpayers’ money was announced for capital expenditure to support elective, recovery, diagnostic and technology over the next three years, and we are rolling out 44 community diagnostic centres to increase capacity. That could deliver up to 2.8 million scans in the first full year of operation. We aim to deliver up to 100 community diagnostic centres in total by 2024-25, and we will publish the delivery plan for tackling the electives backlog later this year. I will, of course, pass on my hon. Friend’s concerns to my right hon. Friend the Secretary of State for Health and Social Care.

Pete Wishart: What an absolute and utter mess, and I am not entirely sure that it has been much helped and assisted by what the Leader of the House said about the process this morning. He is inviting us to capitulate to this Tory kangaroo court Committee, and go along with what the Tories are intending to do on reform. If he wants us to participate, we must return to the status quo. We have to get back to where we were before we voted yesterday, with an intact Standards Committee, and abide by the findings of that Committee. Only on that basis will we enter any discussions or talks with the right hon. Gentleman.
What we have is disgraceful. We effectively have two Committees—perhaps three if the Leader of the House gets his way—that have no legitimacy in the House, no confidence of the membership of the House, and no trust from any members of the public at all. No wonder so many gloomy Tory MPs are kicking around the House this morning—the magnitude of what they attempted to do yesterday is starting to dawn on them. What they did was to legitimise and sanction paid advocacy, and signal a return to cash for questions and grubby brown envelopes stuffed full of cash for doing their paymasters’ bidding. They have effectively dispensed with independent investigation, and they have transferred that to a kangaroo court Committee on which they have given themselves a majority. We will play no part in that Committee of corruption, and I am glad the Labour party will not either.
I heard the Secretary of State for Business, Energy and Industrial Strategy say this morning that the standards commissioner should review her position. That is akin to giving the referee a red card because we do not like the decision of that referee. It is not too late. Return us to the status quo and to where we were yesterday, and we will enter into discussions. But not on the basis of this ridiculous attempt at reform.
Mr Speaker, I have given up trying to get the Leader of the House to wear a face mask. I have now accepted that he does not care a jot about the safety and security of his colleagues or staff in this House. We now have an outbreak in this House, and we have him, with his weird individualism and arrogance, refusing to do anything about it. Maybe that is something that his Tory kangaroo court Committee could look at, because it will have precious little else to do.

Jacob Rees-Mogg: I will just add in response to the hon. Member for Bristol West (Thangam Debbonaire) that I have had a note to tell me that the party chairman responded on behalf of the Prime Minister to the letter on Islamophobia. That was done earlier this year.
Nobody would wish to defend paid advocacy. I would say to the hon. Member for Perth and North Perthshire (Pete Wishart) that his pre-prepared fury every week is becoming very much a broken record. It does not matter what the subject is; the fury is enormous. It may be that it is raining outside and the hon. Gentleman is furious. It may be that there has been a debate on standards and the hon. Gentleman is furious. Anything that comes up, he comes here to be cross, and he gets crosser and crosser as the weeks and the days go on.
If the hon. Gentleman had listened to what I said, rather than concentrating on his pre-prepared fury, he would have noted that I said that we need to make sure that this happens on a cross-party basis. It would be idle to pretend that there are not concerns about the system. It would be idle to pretend that there are not many people in this House who feel that not having a proper appeals process is a flaw in the system. It would be idle to suggest that there are not people in this House who recognise that the system set up for the ICGS, with the IEP, has, with a High Court judge, a better legal focus than the other system. These things are all true and they all need to be looked at, but of course, to maintain high standards and proper processes, we want to have cross-party support.

Peter Bone: I think one of the problems with yesterday was the fact that two issues were being put together; one was the case of my right hon. Friend the Member for North Shropshire (Mr Paterson) and the other was the reform of the system. On what the Leader of the House has said now, I understand the process of going forward on a cross-party basis, but I am not sure how that leaves the case of my right hon. Friend the Member for North Shropshire. Perhaps we could have a statement next week clarifying the Government’s position.
I voted for the Leadsom amendment, as it is called. I listened to the debate and I made up my mind. Will the Leader of the House issue a statement reminding people in the media that all votes in this House are free? I, for one, am never going to be told by someone else not to vote my conscience.
But Sir, the issue that concerns me most—I am sorry to take so long—is that this morning, my office was vandalised because of the way I voted last night. That puts my staff in danger. This is not the way that this should happen. We can have strong disagreement, but I think some of us should remember what happened to Sir David Amess, and perhaps our language needs to be a little temperate. I ask the Leader of the House if we can have a statement next week setting out the Government’s position on what he has said today.

Jacob Rees-Mogg: May I just reiterate what I said at the beginning of these proceedings? While there is a very strong feeling on both sides of the House that there is a need for an appeals process, there is equally a strong feeling that this should not be based on a single case or applied retrospectively. I fear last night’s debate conflated the individual case with the general concern. This link needs to be broken. I hope that answers my hon. Friend’s question.
As regards the vexed question of whipping, as I understand it, all Whips are attendance Whips. My hon. Friend is well known for his independence of mind, and I am sure his constituents are aware of that, but to vandalise some Member’s property or office because of the way that Member voted seems to me to be potentially a breach of privilege, and it may be something that needs to be looked into with considerable care. As you warned us yesterday, Mr Speaker, we always need to discuss these things in a temperate and sensible manner.

Chris Bryant: The problem is, we are in a quagmire now. I fully support the comments that have just been made by the hon. Member for Wellingborough (Mr Bone) and I am sorry for everything that has happened to his office; I think that has happened to quite a lot of MPs over the last few years. I think the message for all of us is that we need to be very careful when we are talking about standards issues, as I have tried to be.
The Leader of the House is quite right that we should never be changing the rules at the last minute for a named individual. There is a potential solution to that, which is that the Standards Committee, on a cross-party basis, could produce another report next Tuesday, which the Government could then put to the House next week to deal with the case of the right hon. Member for North Shropshire (Mr Paterson). I think the Committee would say exactly the same thing, but it would be a means of separating that case out from the issue of the whether we should change the system.
On changing the system, as the Leader of the House knows, because he has given evidence to our Committee, we are already reviewing that. There are decent points to be made about things that could be improved in the system. They are not easy things to resolve, but my Committee will do its best, on a cross-party basis and with independent members—a valuable addition to the process and an important part of establishing the trust of the public—to take that forward.

Jacob Rees-Mogg: I am grateful to the hon. Gentleman for confirming that there are concerns about the system. I think there is a general concern about the investigator  and the adjudicator being the same person. It has been suggested to me on a number of occasions that that should be looked at. I am grateful for his suggestion that we should use moderate language, although it has to be remembered that he was the one comparing what happened yesterday to Russia when he was on the wireless this morning, so I hope he will use moderate language not only when he is in this House. As I say, it is important that this is looked at on a cross-party basis, because we need to have robust standards in which Members have confidence.

Nicola Richards: I was shocked and incredibly disappointed to hear of the Labour west midlands police and crime commissioner’s plans to overhaul the use of stop and search powers across West Midlands police. Yesterday, I wrote to the police and crime commissioner to spell out my disappointment at his proposals. My view, shared by other Members, is that we should be empowering our police officers to use stop and search powers in an appropriate and proportionate way, rather than undermining them and making our streets less safe. Will the Leader of the House make some time for west midlands MPs to debate this issue and ensure that the views of my constituents are represented?

Jacob Rees-Mogg: I am grateful to my hon. Friend for her question. Police chiefs are absolutely clear: stop and search is a vital tool to crack down on serious violence and to keep people safe. That is why we have announced the relaxation of voluntary restrictions on section 60 stop and search powers in all forces in England and Wales. We are also introducing a new court order to make it easier for officers to stop and search those convicted of knife crime. Every weapon seized is potentially a life saved. Last year, stop and search removed 11,000 dangerous weapons from our streets. I encourage my hon. Friend to seek a Back-Bench debate on this matter. I will share her concerns with my right hon. Friend the Home Secretary.

John Cryer: The Leader of the House seemed to indicate earlier that the ICGS system will remain unchanged. Could he now make it absolutely clear that there will not be any changes to the independent system, even if an MP happens to dislike the outcome of a particular case?

Jacob Rees-Mogg: I said that in my remarks yesterday. I had a representation from union officials before the debate, which I thought it important to reply to in order to reassure people who work in the Palace that cases relating to harassment and sexual harassment that come under the ICGS are entirely unaffected by what happened yesterday. They have a different process. They have an Independent Expert Panel as an appeal, organised and presided over by a High Court judge, which I think gives those who may come up before the panel greater confidence in its ability to deliver natural justice.

Jonathan Gullis: My right hon. Friend may think, after a £56 million levelling-up fund, a £29 million transforming cities fund, a £17.6 million Kidsgrove town deal and 550 new Home Office jobs in the city of Stoke-on-Trent, that perhaps we would be rather full up in my constituency, but he will not be  shocked to hear that we have an appetite for more. Potholes drive us potty in the Potteries, so with the announcement in the Budget of £2.7 billion to fix them, does he agree that Stoke-on-Trent should get a big slice, particularly when taking into account the condition and use of our roads, and that congestion delays drivers by an average of more than a minute for every mile travelled?

Jacob Rees-Mogg: My hon. Friend is beginning to remind me of Oliver Twist, in that he is always asking for more. I heard him in Transport questions asking for £90 million and now he wants even more money. He is an absolutely terrific campaigner for Stoke-on-Trent and for getting things done there. There is a £2.7 billion fund over the next three years for local road maintenance, and there is this brilliant JCB device that can mend potholes very quickly. I encourage him to keep on campaigning to get rid of the potholes and to lobby his council to ensure that that is one of its priorities. However, I really commend him for his success in ensuring that any available taxpayers’ money always goes to Stoke-on-Trent.

Wera Hobhouse: It has just been announced in the media that the Government are U-turning and have ditched immediate plans to overhaul the standards system. First, will the Leader of the House confirm that? Secondly, does he agree that we need an urgent debate on the whole issue?

Jacob Rees-Mogg: That was what I said in my statement at the beginning. We wanted to proceed on a cross-party basis and clearly, therefore, the Select Committee not being supported by other parties was not going to be an effective way of doing that. We had a debate on standards yesterday, which took up 90 minutes and was quite comprehensive.

Peter Aldous: With regard to yesterday’s amendment to the Standards Committee’s motion and my right hon. Friend’s statements this morning, both initially and in response to my hon. Friend the Member for Wellingborough (Mr Bone) and the hon. Member for Rhondda (Chris Bryant), I welcome this move, but I emphasise the need to move very, very quickly for cross-party involvement and to allay the concerns that have already been expressed by members of the public. Our credibility is destroyed if we do not nip this in the bud very, very quickly.

Jacob Rees-Mogg: I think we have moved quickly. We recognise that not achieving cross-party support yesterday made it very difficult to get the reforms that we are seeking. We do still seek to have a system that is properly fair and allows a genuine form of appeal, but that cannot be done by the fiat of the Government. It needs broader support than that.

Gerald Jones: One of my constituents, Christopher Crawford, recently changed his name by deed poll and has been experiencing considerable delays in securing a replacement biometric residency card. No other details have changed, but he has been told that the process will take up to six months. As he works in the creative industries, without this card he is unable to prove his identity and to apply  for a covid pass, which is required in Wales in certain circumstances. I have written to the Home Secretary and no action has been forthcoming, so will the Leader of the House arrange for a debate so that we can look at the delays in the Home Office and actions that it can take to expedite matters and militate against circumstances such as these?

Jacob Rees-Mogg: I view it as my role as Leader of the House to facilitate issues of this kind, when Members bring forward specific issues relating to their constituents who are not receiving an efficient Government service. I will therefore take this up with the Home Secretary after business questions, although perhaps if the hon. Gentleman could email to me further details of his constituent and the new name that he has adopted by deed poll, I will do what I can to try to speed up the process.

Kerry McCarthy: As shadow roads Minister, I had spent this week preparing to speak in a Committee on Monday on motor vehicles regulations—that was slightly complicated by the fact that one of the statutory instruments did not seem to have been published. We were told yesterday that that Committee would not go ahead. As a result, I had a conversation with the chair of the all-party group on trailer and towing safety, our neighbour, my hon. Friend the Member for Bristol South (Karin Smyth). It would have saved an awful lot of time and an awful lot of conversation and speculation yesterday if we had been told that the reason why the Committee was pulled was that it would be listed for the main Chamber on Monday instead. To be frank, this has upset rather a lot of people who were hoping that the measures on trailers were not going to go ahead. I would like to know from the Leader of the House why things could not have been tied up and why, when the Delegated Legislation Committee was cancelled, we could not have been told that it was going to be in the Chamber.

Jacob Rees-Mogg: That is a very good question, but the answer is that the Chamber has to be told first the business of the Chamber. That is a courtesy to the House. I appreciate that when things are being cancelled, it is not helpful that people are not informed of the replacement, but it is absolutely standard practice to notify the Chamber first of business in the Chamber.

Patricia Gibson: As the Leader of the House may be aware, I have been highlighting since August the unacceptable delays to state pension payments for the newly retired. Despite protestations from the pensions Minister that all payments would be up to date
“by the end of October”,
today the Department for Work and Pensions has admitted that thousands of newly retired people still do not have their rightful pensions, including many in my constituency of North Ayrshire and Arran. This is causing deep financial distress, not least to the 1950s women who have already had their pension age increased. Will the Leader of the House make a statement setting out what he will do to ensure that the pension system is fit for purpose and that this mess, which has gone on for far too long, will be sorted out once and for all?

Jacob Rees-Mogg: I will tell the hon. Lady what I did the last time she raised the matter: I contacted my right hon. Friend the Secretary of State for Work and Pensions within a few minutes of the end of business questions, and was told that it was expected that the problem would be sorted out by the end of October. I note that the hon. Lady says that that has not happened; I will be in touch with the Department immediately after business questions. I know that the Department deeply regrets the delays that have taken place.

Liz Twist: St Joseph’s Catholic club in Birtley in my constituency has been running a 1 o’clock club in recent weeks, bringing together residents in a social and friendly environment with huge success. We all know that tackling social isolation and loneliness is really important, especially in the light of coronavirus, so will the Leader of the House join me in congratulating St Joseph’s Catholic club on its work? Can we have a debate in Government time on progress towards tackling loneliness?

Jacob Rees-Mogg: Yes, I would very much like to congratulate St Joseph’s Catholic club on its 1 o’clock club and its efforts to tackle loneliness. I note that loneliness can be greatly helped by spiritual fulfilment, which many people find through their religious practices; I am therefore delighted that the Catholic Church is involved in helping to tackle loneliness. I fear that I cannot promise the hon. Lady a debate, but it may be that the Backbench Business Committee would be keen to help.

Rachael Maskell: May I thank you, Mr Speaker, for all the work that you are doing to ensure that Parliament is kept safe for staff and Members? May I say to the Leader of the House that this place is not safe? Around voting time, the Lobbies around the Chamber are rammed with many of his colleagues who are not wearing face masks, putting us all at risk. I ask him to review that with you, Mr Speaker, and with others in this House.
The housing crisis in York is growing and it seems that the Government’s proposals around planning have run into the long grass. Could we have a debate in Government time to look at housing need and tenure need in order to address the housing crisis that we are seeing in our constituencies?

Jacob Rees-Mogg: The hon. Lady raises a matter that is of concern across the country: how we have a planning system that provides the number of houses that we need and ensures that the right number of permissions are granted every year to achieve the targets and to allow people to own their own home, which is the fundamental aim of planning reform. It was announced in the Queen’s Speech that there would be a planning Bill, and it is the intention of Her Majesty’s Government to deliver a planning Bill.

Lindsay Hoyle: Finally, the voice of Bradford: Judith Cummins.

Judith Cummins: Thank you, Mr Speaker. I am sure that the Leader of the House and the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup), who is in her place, will be interested to know that 30 million NHS dental appointments have been lost since the start of the pandemic. Access to urgent treatment is delayed and my constituents continue to struggle to find an NHS dentist. Can we have a debate in Government time on funding and access to NHS dentistry?

Jacob Rees-Mogg: The hon. Lady will know that there is a very considerable catch-up plan for the NHS, including £5.4 billion over the next six months, but at the height of the pandemic, the very immediate contact that patients have with a dentist was thought to be a particularly high risk. However, I know that dentists are now very much back to work; indeed, I have visited dentists in my constituency who are extremely busy working through the backlog. We should be grateful to them for the work that they are doing, but the resources are being provided to help with it.

Covid-19 Vaccinations

Maggie Throup: With permission, Mr Speaker, I will update the House on our covid-19 vaccination programme.
It is less than a year since Margaret Keenan made history by becoming the first person in the world to receive a covid-19 vaccination outside a clinical trial. Since then, we have been leading the world with our vaccination roll-out. We should all take huge pride in the progress that we have made. We have now delivered more than 100 million doses across the UK, including more than 50 million first doses, more than 45 million second doses, and more than 8 million booster and third doses. The UK Health Security Agency estimates that our jabs have prevented more than 24 million infections and more than 127,000 deaths.
Winter is always a challenging time for the NHS, but this year it is even more so, with more indoor mixing, the circulation of flu, and a new risk of more covid-19 variants.
We must continue to do everything we can to protect ourselves, our loved ones, and our NHS. The vaccine roll-out is our best defence against the virus, and it remains the Government’s top priority. While more than 90% per cent of adults across the United Kingdom have received their first dose, about 5 million adults are yet to come forward, but it is never too late to come forward, and we will continue to help everyone to get their jabs so that no one is left behind.
Data published last week by the Office for National Statistics shows that the risk of dying from covid is 32 times greater in unvaccinated people than in fully vaccinated people. That only underlines what we already knew—the critical importance of vaccination—and we are committed to making getting booster jabs as easy as possible. More than 2,400 vaccine sites are now in operation across England, and people can access a vaccination via a walk-in site or book an appointment regardless of whether they have an NHS number. We recognise that the chance to book a jab early, even before the eligibility date, has the potential to drive up bookings for boosters, and we are considering that carefully.
We will not ease up on vaccine uptake, and will continue to work with clinicians, social media platforms, local authorities, faith groups and businesses—indeed, with anyone who can communicate the benefits of vaccination. We have funded community champions across the country to work with local leaders and communities to encourage people to come forward.
We have also accelerated our vaccination programme for children and young people. All those aged 12 to 15 can now get their vaccinations at school, or by booking an appointment via the national booking service. More than 200 sites are now available for appointments outside school, and school age immunisation teams have visited more than 2,500 schools in England so far, with 800 more due to be visited next week. I am delighted that more than 650,000 12 to 15-year olds have been vaccinated since the programme was launched in September.
We are also rapidly rolling out our booster programme to give people the best protection over the winter and help to reduce pressure on the NHS. Although our vaccines give powerful protection, we know that the  levels of protection offered by a covid-19 vaccine fall over time—particularly in older people, who are at greater risk from the virus—and even a small reduction in protection can have a significant impact on hospital admissions. The goal of the booster programme is to top up that protection. More than 8 million people across the UK have now received the vital protection that a booster dose provides. Our brilliant NHS is delivering the biggest vaccination programme in NHS history, administering hundreds of thousands of booster jabs every day, and the pace has been accelerating rapidly, with a record 1.6 million jabs in England last week alone. A further 2.2 million invitations are going out this week.
Doctors, nurses, pharmacists and volunteers up and down the country are playing their part in delivering jabs to protect the country against the virus. GPs in particular continue to be the bedrock of the vaccine programme, delivering more than 70% of all vaccinations so far, and I know that the whole country is grateful for their tireless work throughout the pandemic.
The most important thing that everyone can do to protect themselves, their family and the freedoms for which we have fought so hard is to get their jab and, if they are eligible, their booster dose. We are making it easier than ever to get protected, so please come forward.
People eligible for their booster can already use the NHS online walk-in finder to find the most convenient site to get their top-up without an appointment. There are hundreds of walk-in sites across the country. We have also updated our guidance to make it clear that covid-19 boosters can be given slightly earlier to those at highest risk, where it makes sense operationally. For example, we are allowing care home residents who may have received their second dose at different times to be vaccinated in the same session when the vaccination team are in the home, as long as they have passed the five-month mark.
Covid-19 is not our only adversary this winter. We are also facing the threat of flu, which even before this pandemic, placed a great strain on the NHS at this time of year. Last season, we saw extremely low influenza activity levels globally and as a result, we may see lower levels of population immunity against the flu and more strains in circulation this winter. To combat this, a record 35 million people are eligible for a free flu jab this year, and this provides us with another way that we can keep our country safe.
Finally, it is not just in vaccinations that records are being set. I am delighted to confirm that today we have become the first country in the world to approve an antiviral for covid-19 that can be taken at home. In clinical trials, molnupiravir has been shown to reduce the risk of hospitalisation or death for covid-19 patients who are most at risk by 50%. This treatment has gone through a rigorous assessment for the highest standards of safety by the Medicines and Healthcare products Regulatory Agency. We are now working across Government and the NHS to urgently get this treatment to patients, initially through a national study so that we can collect more data on how antivirals work in a mostly vaccinated population. I urge everyone to get their covid and flu jabs as soon as they are eligible, in order to protect themselves, their loved ones, and the extraordinary progress that we have made together. I commend this statement to the House.

Rosena Allin-Khan: I thank the Minister for giving me advance sight of the statement and take this opportunity say a huge thank you to our NHS. Frontline staff are doing a fantastic job continuing to deliver the vaccine programme, which is especially complex and fraught with challenges as they deliver first, second and third doses as well as jabs for 12 to 15-year-olds. They are coping with numerous pressures in the system, but continue to work flat out to get the UK through this pandemic.
Winter is coming, though, and frankly the Government just do not have a handle on covid, going into the busiest season for our NHS. The Government must get a grip on the stalling vaccination programme. Plan B, which contains measures that we already support, such as mask wearing and allowing working from home, is simply not enough on its own. Yes, we support it, but it is not enough on its own. We must turbocharge vaccine boosters, fix sick pay and improve ventilation.
The clinically vulnerable are simply not getting the jabs they need. Local residents are contacting us saying that they cannot get the boosters they so desperately need. One lady in her 70s who has underlying health conditions went to her pharmacy and called 119, just to be told that she was not eligible for her booster. She has now finally got one booked for December, but she had to rely on her daughter to book the appointment for her because she does not use the internet. The system simply is not working, particularly for many of those who need it most.
The Government had a deadline of 1 November for offering booster jabs to all care home residents. Right now, only 23% of care home residents in Leicester have had their booster jab, and the picture across the country is extremely patchy. To be clear, just promoting pop-up vaccine clinics does not help care home residents. We must use all the resources we have, including community pharmacists, retired medics and trained volunteers, to go into care homes and vaccinate residents. The Government are failing and this is putting people’s lives at risk.
In my borough of Wandsworth, the two-dose rate is only 67%, which means that almost 100,000 people do not have the recommended level of vaccination, but this is not an isolated example—people in Wandsworth are working very hard to get the vaccine out—and it is replicated across the country. What are the Government doing to increase the uptake?
Let us be honest, it is largely less affluent areas that have the lowest take-up, proving that vaccine inequalities are alive and kicking. Covid has shone a spotlight on the health inequalities that exist across the country. Why are the Government ignoring them again now? We are tired of issuing the same warnings time and again.
Our rate of child vaccination is shamefully low and slowed during half-term—the rate is still only around 20%. There were almost 250,000 children out of school in the days before half-term. Where is the plan?
On current trends, we will not complete the booster programme until spring 2022. The Government need to get a grip and set a target of 500,000 boosters a day. At the moment, the figure is less than 300,000 a day, which is why we are calling for more pop-up vaccine clinics, greater use of community pharmacies and the mobilisation of retired medics.
As we approach a difficult winter, Ministers have failed to put in place measures such as improved ventilation, proper sick pay and fully resourced local contact-tracing teams, all of which would help to reduce the spread of the virus. We must get the balance right and ensure flu vaccines, covid vaccines and boosters are all delivered at a high pace from now until the end of winter. While the booster scheme is so slow, the Government should never have scrapped mask wearing and working from home. The Prime Minister should never have abandoned those measures.
The Government have failed to plan yet again, and they are putting the country at risk going into winter. We need less bluster from this Government, who seem to spend more time planning to protect their mates than the lives of people up and down the country. We need action now.

Maggie Throup: Ninety per cent. of the adult population have had their first dose, and 8 million people have taken up the opportunity to have a booster jab. That is a successful vaccination programme, so I will take no lessons from the hon. Lady.
The hon. Lady talks about care homes and, from a personal point of view, I know how important it is to make sure our most vulnerable are vaccinated, which is why I am delighted that nine out of 10 care homes have had their jabs either delivered or booked. That is a great success.
This Government have already recognised that covid has exposed the disparities across the nation, which is why on 1 October we launched the Office for Health Improvement and Disparities to understand what is important and how we can make real change in our communities that need the most help.
The hon. Lady talks about bringing back retired medics and volunteers, but they are already back. They have been playing their part for months, and I take this opportunity to thank them for all their efforts. Just last week, I met a retired medic who had come back to St Thomas’ Hospital, and he was relishing his role in this amazing vaccination programme. The hon. Lady does those volunteers and returners a huge disservice.
I am always grateful to the hon. Lady and the right hon. Member for Leicester South (Jonathan Ashworth), because throughout this pandemic they have usually been co-operative, helpful and in agreement with us, but the hon. Lady’s remarks today give too little credit to the phenomenal role that the NHS and community pharmacies are already playing in the roll-out of our vaccination programme. They are delivering a booster programme of third doses while delivering the largest flu programme ever, with 35 million people now eligible for a flu jab. I call on people to come forward as soon as they can.

Jeremy Hunt: My apologies, Mr Speaker, for missing the start of the Minister’s statement because you managed to expedite parliamentary business with commendable briskness this morning.
I thank the Minister for her update. Let me say how welcome it is that we have approved the new antiviral, molnupiravir—a new word for us to memorise—which could be immensely significant. When does she think we will be able to distribute it to people who have caught covid who are at home? She says that there is  going to be a national study, which is potentially an important step. However, in a pandemic we sometimes bypass these national studies and go straight to distributing medicines that we know are safe to members of the public. Might this not be one of those occasions where we decide to speed things up? I also commend her efforts on the vaccine programme, but, as the shadow spokesman said, one reason we are behind other European countries on vaccinating teenagers is that the Joint Committee on Vaccination and Immunisation did not give its decision until September, whereas France was able to start vaccinating before the summer holidays. Is she looking at how we could speed up the JCVI processes? I appreciate that her hands are tied.
May I also ask the Minister to look at the booking system, because in parts of my constituency people are not able to book a booster jab until after they have passed the six-month mark? Would it not be better for anyone to be able to book their booster jab after they have passed the five-month mark? Finally, may I ask her when she is planning to tell the House about the very important decision on mandatory jabbing for NHS workers? That is a difficult decision. It is one I would support if the Government brought it to the House. I have read in the press that they are thinking of doing that in the spring, which mi well be the right timing, but this is something that NHS staff want to know about.

Maggie Throup: I thank my right hon. Friend for his questions. I reiterate on the antivirals that we are working across government and the NHS to urgently get this treatment to patients. As he rightly says, it is important that we act very quickly. It was only earlier today that the Medicines and Healthcare products Regulatory Agency gave its approval, so we are already taking rapid steps in letting people know about this issue. He talked about the JCVI, for which I have huge respect. I do not think it is my position to intervene in its processes. We need robust processes to make sure that what we have available and the programmes we have are very safe, as the UK population would expect. He also talked about booking the booster. We always need to look at ways of improving accessibility, but we did open up the opportunity for people to go to walk-in centres for their booster, so that they do not need to book online or call 119. We are looking at ways of making this easier all the time. On the mandating of jabs, the Secretary of State will make an announcement in due course.

Marion Fellows: I thank the Minister for previous sight of her statement. Scotland leads the UK in both first and second vaccination rates: 90% of those aged over 12 have been vaccinated with at least one dose, whereas in England the figure is 85; for second doses, the figures are 81% as against 79%, with booster roll-outs taking place across these lands as we speak. How do the UK Government plan to match Scotland and encourage greater uptake of vaccines among those who are so far unvaccinated?
The Government said in their Budget that they planned to invest responsibly. Does the Minister believe it was responsible to cancel a multi-million-pound contract—threatening hundreds of jobs in Livingston for no good reason— to supply a covid-19 vaccine that phase 3 trials show may be more effective than the Oxford vaccine? Will she rethink that outrageous decision?

Maggie Throup: I thank the hon. Lady for her update on what is happening in Scotland. I commend those involved in the roll-out of the vaccination programme in Scotland. We can all learn lessons from each other in this pandemic and it is only right that we do so. On the contracts the hon. Lady talked about, I will not comment on commercial decisions.

Lucy Allan: I thank the Minister for her statement and the excellent work that she and her team are doing to roll out boosters as fast as possible. I urge her to consider whether bookings for boosters could be made in advance, so that people are already booked in when they become eligible and can immediately have their booster.

Maggie Throup: I reassure my hon. Friend that we always look at ways to make it easier for people to get their booster, as well as for people to get their first and second jabs and their flu jab. We are always open to looking at opening up further opportunities.

Sarah Owen: The Minister said earlier that she will not take any lessons from Labour on this issue but, given we have one of the highest death rates in Europe, perhaps she should.
I want to talk about one of the most vulnerable groups of people who have been left unprotected throughout this pandemic. One in six of the most critically ill covid patients in the UK are unvaccinated pregnant women. What are the Government doing to protect pregnant women now and throughout the ongoing pandemic?

Maggie Throup: The hon. Lady makes a very good point. I find it really concerning that one in six people in hospital with covid are unvaccinated pregnant women and it is an issue that I wholeheartedly want to address. I encourage every lady who is either looking to become or is pregnant to talk to their midwife and their GP and get reassurance that vaccines are safe for that cohort of ladies. The best thing they can do is to protect themselves and their babies.

Peter Bone: I got my jabs on time, I then managed to get covid—probably from this place—and I have also had my booster jab. I understand from the Minister that there is a new antiviral drug; how would that have been given to me when I was quite poorly with covid? When we have new drugs, can we give them easier names to pronounce?

Maggie Throup: My hon. Friend makes a good point: I do not know why the pharmaceutical companies come up with these tongue-tying names for their drugs. As I said earlier, we need to make sure that we roll out the new antiviral to the right people. The important and exciting thing is that the drug can be taken in people’s homes.

Catherine West: Today marks the day when we have the most covid cases ever, so it is a sad day for the UK.
My concern is schools. The advice is that ventilation works against covid, yet schools are desperately underfunded for ventilation measures. Will the Minister speak to the Minister for School Standards to ensure  that the budget for such measures can be refreshed so that all children, staff and families can be as protected as possible from covid?

Maggie Throup: I agree with the hon. Lady that it is so important to protect our youngsters. A lot of investment has gone into making sure that there is ventilation in schools, but I will talk to my counterpart in the Department for Education to see whether more can be done.

Duncan Baker: I recognise the enormous amount that is going into the booster programme and thank the Minister for that. In Norfolk and Waveney we are already up to nearly 55% of all eligible constituents having had their boosters, but my North Norfolk constituency has a particularly elderly demographic and we have no walk-in booster availability at all. I urge the Minister to put pressure on my local clinical commissioning group, given the worry it causes for the elderly demographic, to make sure that people can access walk-in booster jabs as quickly as possible.

Maggie Throup: I think my hon. Friend has already got his message over loud and clear to his CCG, but we can have further discussions if he finds that has not worked.

Daisy Cooper: I am grateful to the Minister for having fixed the problems with the booster booking system that I raised with her two weeks ago, but the system for third jabs for the clinically extremely vulnerable is still in total chaos. Some clinically vulnerable people are saying that their GPs do not know which group they are in and, even if their GPs do know, those people who are eligible for their third dose and their jabs cannot be identified on the online system. Will the Minister commit to fixing the system in the next 48 hours and urgently reinstate the monthly meetings that her predecessor held with patient groups, which have been trying to bring these concerns to her attention?

Maggie Throup: The hon. Lady raises an important issue. However, it is important that, for that individual whose GP is not able to give them a jab, they have words with their hospital consultant who may have more knowledge of their condition. I will definitely look into the system.

Andrew Jones: I thank my hon. Friend for her statement. Delivering 8.7 million booster jabs at 2,400 vaccination sites is a great achievement. I agree entirely with the point about making booster jabs as available as possible. On that point though, in North Yorkshire, where we have had fantastic vaccine roll-out and take-up—it has been a great achievement—I am hearing mixed messages about  what is happening in schools. The CCG has told me that they should be eligible for visits by the end of this month, but some schools have been reporting that they are not looking at visits until January or February next year by which stage, of course, it is too late. If I look at the website on the location of walk-in centres and tap in Harrogate, it brings up five locations in Halifax, which is about 17 miles away. Are there any problems with vaccine supply, or are we having some difficulties in North Yorkshire at the moment?

Maggie Throup: I can reassure my hon. Friend that there is no problem at all with the supply of vaccines; we have plenty of supply. He talks about schools. The vaccine programme in schools is being carried out by the school-aged immunisation service, which is very experienced in carrying out vaccinations for different conditions in schools. If there is a problem in his area, I will definitely look into it on his behalf.

Rachael Maskell: I cannot accept that the deaths of 217 people yesterday and 293 the day before shows good management of this pandemic. The fact that so many people are now dying of this virus is a call on Government to take urgent action. With the Minister’s own confession that 5 million people are yet to be vaccinated and the fact that my constituents are not able to get access to the flu vaccine either, it is clear that we are heading for a real health crisis. Will she urgently take back the message that we need greater public health measures to be introduced in order to keep our communities safe?

Maggie Throup: No death is acceptable and my condolences go to everyone who has lost somebody in this terrible pandemic. Our best wall of defence is through vaccinations. Vaccinations do work, so my message is: get your booster. If people have not had their first jab, they should get their first jab and continue to build that wall of defence.

Wera Hobhouse: Many of my Bath constituents have got in touch to say that they have trouble getting access to the booster vaccines. This is particularly worrying for the clinically extremely vulnerable, as we have already heard. The support for the clinically extremely vulnerable has been woefully inadequate, including the advice that they were given throughout the pandemic. As we head into winter, what guidance is the Minister giving to the 3.7 million people who were advised to shield last winter?

Maggie Throup: I think it is important that everybody takes personal responsibility and makes sure that they protect themselves. As we know, people were shielding last winter, but we did not have this highly successful vaccination programme. The best way for people to protect themselves is to get jabbed, get protected and to protect themselves from the virus.

Committee on Standards

Application for emergency debate (Standing Order No. 24)

Lindsay Hoyle: I now call Wendy Chamberlain to make an application for leave to propose a debate on a specific and important matter that should have urgent consideration under the terms of Standing Order No. 24. The hon. Member has three minutes in which to make such an application.

Wendy Chamberlain: I seek leave to propose that the House should debate a specific and important matter that should have urgent consideration, namely the matter of the consequences of the decision of the House on 3 November relating to standards.
This morning, Lord Evans, Chair of the Committee on Standards in Public Life said:
“In my view yesterday’s vote on the report of the Commons Standards Committee was a very serious and damaging moment for Parliament and for public standards in this country.”
We would all do well to reflect on those words.
The consequences of yesterday’s vote are clearly far reaching. Matters referred to and emerging from the Commons Standards Committee should never be a matter for the Government; they should be the business of this House and this House only. The Government’s decision not just to meddle in an independent process, but then to whip Conservative Members to get what they wanted is one of the worst overreaches of Executive power that this House has seen in its history.
It is vital that there are clear and high standards that are upheld, particularly by those in positions of responsibility. For example, as a former police officer, I, and others across the House, have been engaged in recent weeks on the conduct of those within the police service. It is shameful that this Government will not apply the same standards of scrutiny to behaviours within their own party. We have seen an attempted U-turn by the Government this morning, but the fact that the Leader of the House is proposing a different review of processes, without the scope for debate, demonstrates even further the contempt with which this place is being treated. The Government want to silence us.
The remarks by the Leader of the House this morning mean that we do not yet know the full consequences of yesterday’s vote, but we do know that we have already  seen a Government Minister on television this morning questioning the future of the current independent Commissioner for Standards. I am hugely concerned that the Leader of the House is leaving the door open for further attacks on this independent process.
My right hon. Friend the Member for Orkney and Shetland (Mr Carmichael) talked yesterday about a need for consensus, and there are areas where I agree with the Leader of the House. There must be standards that are fair and robust, and which are seen to be fair and robust, but the Government’s short-sighted intervention to protect a colleague, using a political process to overturn in two hours an independent investigation that took two years is the complete opposite of fair and robust. That is why this House must have a debate on the consequences of yesterday’s vote. The statement by the Leader of the House this morning left far more questions than answers. The system will only be fair and robust when this debate has taken place.

Lindsay Hoyle: The hon. Member asks leave to propose a debate on the specific and important matter that should have urgent consideration—namely, the matter of the consequences of the decision of the House of 3 November relating to standards. I have listened carefully to the application from the hon. Member and I am satisfied that the matter raised is proper to be discussed under Standing Order No. 24. Has the hon. Member the leave of the House?
Application agreed to (not fewer than 40 Members standing in support.)

Lindsay Hoyle: The hon. Member has obtained the leave of the House. The debate will be held on Monday 8 November, as the first item of public business. The debate will last for up to three hours and will arise on a motion that the House has considered the specified matter set out in the hon. Member’s application.
Can I just say, once again, that this has not been a good period for the House? It has been a very difficult time for all. I appeal to Members, whether they are Secretary of State or whoever: please—staff members of this House should not be named, as they do not have the right of reply or the ability to defend themselves. I am appalled that Sky News is more important. Please, rein in your thoughts and consider what you are doing to the individuals concerned. They also have to live through this, like the rest of us. Please consider your behaviour and start acting responsibly, in accordance with the position that you hold.

Sanctions

Wendy Morton: I beg to move,
That the Republic of Belarus (Sanctions) (EU Exit) (Amendment) (No. 2) Regulations 2021 (SI, 2021, No. 1146), dated 11 October, a copy of which was laid before this House on 14 October, be approved.
The instrument before us was laid on 14 October under the powers provided by the Sanctions and Anti-Money Laundering Act 2018, also known as the Sanctions Act. It amends the Republic of Belarus (Sanctions) (EU Exit) Regulations 2019 to introduce new measures in the financial, trade and aviation sectors. The regulations that we are debating today revoke and replace the Belarus sanctions regulations laid in August 2021, which contained an error that had the effect of deleting a prohibition on the transfer of restrictive technology to Belarus—that is, military and interception or monitoring technology and technology used for internal repression. These regulations correct that error. I can assure hon. and right hon. Members that there was no continuity gap between the effects of the two sets of regulations.
The Government, along with international partners, decided to increase targeted sanctions because the situation in Belarus continues to deteriorate. On numerous occasions, Lukashenko and his regime have violated democratic principles and the rule of law and violently oppressed civil society, democratic opposition leaders and independent media. This includes the forced diversion of Ryanair flight FR4978 on 23 May in order to arrest the journalist Roman Protasevich and his partner Sofia Sapega. Lukashenko sent in a MiG fighter jet to force the Ryanair plane to land, endangering not only Protasevich and Sapega but everyone else on board. This also showed a flagrant disregard for international aviation law. The couple remain in the custody of the Belarusian authorities. The UK Government reiterate their call on the Belarusian regime to release them and to release all those held on political grounds. The regime has enforced the arbitrary detention of more than 35,000 people and imprisoned more than 800 people on political charges. The United Nations and the Organisation for Security and Co-operation in Europe have recorded many credible reports of physical mistreatment, including torture, by the penal and security forces in Belarus.
Opposition figures have been harassed and forcefully expelled, and this year Belarus introduced new legislation to further suppress media freedoms and peaceful assembly. The UK supports all those working for a more democratic future for Belarus. We were delighted to welcome Sviatlana Tsikhanouskaya, leader of the Belarusian democratic opposition, to the UK on 3 August. I was pleased to be able to meet Ms Tsikhanouskaya during her visit, as did the Prime Minister and the former Foreign Secretary, and we reiterated our support. Ms Tsikhanouskaya emphasised the need for further sanctions on the Belarusian regime and commended the UK for taking action.
This instrument enshrines in law our increased sanctions measures on the Belarusian regime, showing that we stand with the people of Belarus. Our sanctions are carefully targeted to build pressure on Lukashenko, state institutions, and those around him while minimising any unintended consequences for the ordinary of people  of Belarus who are suffering under authoritarian rule. The measures that it introduces prevent any UK business from trading goods and services with Belarus in sectors that are key sources of revenue for the Lukashenko regime. They limit the regime’s access to items that could enable the internal repression of the Belarusian population, including potash, petroleum products, and interception and monitoring goods and technology. They also cover goods used in cigarette manufacturing, dual-use goods, and technology for military use. We have imposed a prohibition on technical assistance to aircraft where this would benefit persons designated for that purpose. This ensures that UK companies cannot provide services in relation to President Lukashenko’s fleet of luxury aircraft.
Financial measures prohibit dealing with transferable securities and money market instruments issued by the Belarusian state and public bodies, as well as those issued by state-owned banks and the provision of loans. This puts additional pressure on the Belarusian regime, including by preventing future Belarusian Government bonds from being listed on the London stock exchange. This comprehensive response also includes prohibitions on the provision of insurance and reinsurance to Belarusian state bodies, and prohibits the export of biathlon rifles by removing a licensing ground under the arms embargo.
The aviation measures prohibit Belarusian air carriers from overflying or landing in the UK, and that continues the temporary measures we put in place after the events of 23 May. Finally, the measures also give us the power to designate persons for providing support for or obtaining an economic benefit from the Government of Belarus. Since those measures came into force, we have made a further designation under the Belarus sanctions regime under this criterion. UK sanctions action, taken together with our allies, aims to encourage the Belarusian regime to respect democratic principles and institutions, the separation of powers and the rule of law in Belarus. The sanctions also aim to discourage the regime from actions, policies or activities that repress civil society in Belarus and to encourage it to comply with international human rights law.
We regularly review our sanctions and would consider lifting them if we saw significant progress. However,  in the case of Belarus, we have seen no progress and  the situation continues to deteriorate. Sanctions are most effective when implemented in co-ordination with international partners, and our measures were co-ordinated in June with the EU, the US and Canada, and we will continue to work closely with them on Belarus. Similarly, actions work best when combined with other diplomatic and economic measures, and the UK has assisted independent media and civil society organisations in Belarus, which continue to face unparalleled levels of pressure from the regime. By the end of this financial year, our programme of support to Belarus will have almost tripled since 2019.
The UK unequivocally condemns the appalling campaign of repression waged by the Belarusian regime against the rights and freedoms of the Belarusian people. The regime has oppressed civil society, rejected democratic principles and violated the rule of law. The regulations expand our sanctions in response to the situation on the ground. They demonstrate that we will not accept such egregious violations of human rights. They enable us to stand with our international partners and, most importantly,  with the people of Belarus in working towards a peaceful, prosperous and democratic future. I welcome the opportunity to hear the views of Members on the regulations, and I commend them to the House.

Catherine West: I welcome the Government bringing forward an amended schedule of sanctions, due to some errors in the laying of the sanctions in the House earlier in the year. Today I am wearing my green and purple, because the Minister and I are both aware of how much women activists in Belarus have suffered in the past couple of years, in particular having many of their partners and husbands locked up. They are therefore now in the spotlight politically. They have not chosen to go into politics in the way that we might, but have been forced to by circumstance.
Across the House, I know that every woman MP, including the leadership we have had from our own parliamentary Labour party women’s group, stands up for those women, their right to be human rights activists and their right to be women in the workplace and defends their right to the Belarus of the future that they wish to see. There is nothing worse than seeing a leader getting out of an aeroplane the day after a sham election dressed in black with a rifle on his shoulder, and the terror those people felt at that moment.
It has been wonderful to see the cross-party approach and the support we have had from trade unions, civil society groups, students and the diaspora here in the UK to stand up against the Lukashenko regime and put on record our anger, concern and sadness at what has happened in the past two years. There have been 35,000 arrests and 800 political prisoners—in Europe.
Members from all parts of the House gather together, despite our differences—and we have had a few in the past 48 hours—to say today that we stand with those women for freedom and for the rights that they and their families want to have. The level of brutality that the Belarusian regime is regularly using on its own people was on show for the world when the Ryanair flight was dangerously hijacked—the Minister has already gone into detail about that. Those two activists are still in prison, and today we send out a message from this House that we are on their side and we will not see this regime continue for too much longer. I pay particular tribute to my hon. Friend the Member for Rochdale (Tony Lloyd) and the all-party parliamentary group on Belarus, which is cross party across both Houses, and to the human rights defenders, journalists and trade unions for keeping the issue in the minds of so many across Europe and in the region. It is heartening to see smaller countries such as Lithuania, Latvia, Estonia and Ukraine, as well as the Polish Government and many across parties in Poland, standing up for the rights of those women and all those activists who want a fresh start.
On the sanctions, it is vital that we do all we can through our economy and through what we say in this House to stop any use of or facilitation through our legal, banking or accountancy services in the UK that could help anyone who has stolen resources from the Belarusian people to launder them through our system. The people of Belarus are entitled to democracy and free elections and we must uphold those principles.
As such, Labour Members welcome the tougher sanctions. I am sure that the Minister agrees that it is vital for our voice in this House to be heard today by the Belarusian people. I hope that we can somehow get the message through particularly to those prisoners of conscience who long for their case to be heard.
As the noble Lord Collins outlined in the other place, we welcome the changes that the statutory instrument outlines to rectify some of the mistakes in previous sanctions, while adopting additional measures in response to the deteriorating behaviour of Mr Lukashenko and his regime. We particularly welcome measures on financial sanctions and measures that seek to remove the ways that the regime has continued to financially sustain itself in the past 18 months. We welcome the inclusion of sanctions on potash exports, which are one of the major exports of Belarus, and which have been continually highlighted as a key way to hold the regime to account.
I have some brief questions for the Minister. First, how will the Government measure the effectiveness of the sanctions, particularly in the light of the ever-diminishing Foreign, Commonwealth and Development Office budget? Secondly, we know that international co-operation is vital to ensure that our actions are co-ordinated with our allies and partners and to ensure that maximum influence is put on the regime. Will the Minister outline what additional measures she is taking to work with European partners to ensure that our actions are in line with theirs and that there is a global strategy for protecting the people of Belarus?
Thirdly, I would welcome the Minister outlining whether there has been any recent assessment of Russian support for the regime in Belarus. Given that the relationship between the UK and Russia is strained, what levers could she use to try to influence Moscow so that we can see more freedom and justice for all those political prisoners who we in this Chamber want to support?

John Howell: It would be wrong for the Minister not to be aware that the sanctions have tremendous support from Conservative and Opposition Members. I speak as the leader of the UK delegation to the Council of Europe, where we have taken a strong stand against Belarus; the false presidential election that took place, about which we made a firm statement; and the bringing down of the Ryanair flight. The Minister may be aware that our delegation—I am told—was the first international delegation to issue a condemnation of Belarus at the time and that that did not go unnoticed. I thoroughly approve of the sanctions.
To pick up on the point of the hon. Member for Hornsey and Wood Green (Catherine West), I am one of several Members of this House and of the other place who is a penfriend, if I can use that term, of Belarusian political prisoners. We write to them to try to provide some comfort and a link to the real world. I know that was mentioned in the other place to great approval, and I hope that mentioning it here will meet equally great approval.
The point to bear in mind and to watch for the future is the crisis of migration on the border of Belarus and the neighbouring countries. The winter is setting in, and I understand that some deaths from cold have already occurred there. Something needs to be done about that very quickly. When I was in Poland recently, I was able  to raise this point with various people—not that we came up with a solution, because the solution effectively lies in placing proper sanctions on the Belarusian Government to make sure that this is picked up and dealt with.
In conclusion, I very much welcome these sanctions as a helpful aid in giving us the strength to deal with the Belarusian Government, so that we make sure that we get real change there.

Stewart McDonald: We welcome the measures by the Government—we have no objections to them whatever—and I do not think there is any point in detaining the House on this any longer than we must.

Wendy Morton: I welcome the support from the Opposition spokesman, the hon. Member for Hornsey and Wood Green (Catherine West), and I am very grateful for the contribution from my hon. Friend the Member for Henley (John Howell). He takes a really close interest, as do many colleagues from across the House, in Belarus, as I saw recently at an all-party parliamentary group meeting that I attended. I am grateful to all the hon. Members who contributed to our short but very important discussion.
I will briefly address the questions raised. On the effectiveness of sanctions, we obviously continue to monitor all the sanctions that we have in place. It would be wrong of me to pre-empt any future designations, but let me assure the hon. Member for Hornsey and Wood Green that we keep a very close eye on such matters. As I set out in my opening speech, we work very closely with a range of international partners to co-ordinate our sanctions regimes.
As I have said, these regulations give us the power to impose sectoral sanctions that have real impact—an impact that is magnified through co-ordination with our international partners. These sanctions ensure that we can target the sectors of the Belarusian economy and the key figures in the Belarusian regime that generate funds for the regime, including those who provide support for, or obtain an economic benefit from, the Government of Belarus but who have not previously been designated. The regulations also demonstrate that the UK will not stand by in the face of the regime’s unacceptable behaviour; we are ready and willing to act as part of a network of liberty, and will stand with those who believe in democracy.
I sense there is support across the House for the sanctions, for which I am very grateful, and I hope the House will support the regulations.
Question put and agreed to.

Backbench Business

Afghanistan: Inquiry

[Relevant document: Oral evidence taken before the Defence Committee on 26 October 2021, on Withdrawal from Afghanistan, HC 699.]

Tobias Ellwood: I beg to move,
That this House has considered the proposal for an inquiry into the UK’s involvement in the NATO-led mission to Afghanistan.
This could be a very short debate if the Minister intervened and said, “Yes, we are going to have an inquiry”; then we could all go home. However, I suspect we will have to work a little bit harder than that.
I thank the Backbench Business Committee for granting this important debate on Afghanistan. This was one of the longest military campaigns in modern history. Over 100,000 armed forces personnel were deployed to Afghanistan, and 435 did not return alive. Thousands did return, but with life-changing injuries, and over 3,500 personnel from other NATO forces were also killed. About 70,000 Afghans lost their lives, although I do not think the true number will ever be known.
The campaign cost the international community trillions, but after two decades we decided to exit before the job was done, handing back the country to the very insurgency we went in to defeat. The country is now run by the Taliban, but they are not in control. It is in freefall, and the freezing winter that is approaching is likely to cause the biggest humanitarian disaster in a generation. The list of challenges we faced, and the lessons to be learned, are huge, yet the Government stubbornly refuse to hold an independent inquiry. Do they think that there is nothing to learn, or—more importantly—to explain to those who served, and to the families of the bereaved? What was it all for?
It is clear that our world is getting more dangerous, and global insecurity is increasing. Our decision to leave Afghanistan added to that. If we have any aspiration, as spelled out in the integrated review, to be a problem-solving, burden-sharing nation, we need to understand how the most powerful military alliance ever formed could not complete its mission after 20 years. If we do not analyse, appreciate and learn from our mistakes, we are likely to repeat them. More critically, this House of Commons is—let us be honest—not so versed in the details, and it will have no confidence in voting to send our troops into harm’s way, fearful of a similar outcome. We will become more risk-averse, and we will end up steering clear of overseas engagements and having no appetite to intervene. Our competitors will enjoy our self-inflicted weakness.
The first rule of war is: know your enemy. That is a prerequisite for any engagement. On my various visits to Afghanistan over a decade, I was always taken aback by the limits of international forces’ local understanding. Yes, they knew their local mission, but how that fitted into the higher commander’s intent was not clear. There seemed to be a national plan to kill the enemy, but that did not knit together with any form of strategy relating to governance, or development programmes outside Kabul. Had we done our homework, checked the archives  and visited that famous Foreign and Commonwealth Office map room, we would have reminded ourselves of what and who we were taking on. We would have been in a better position to advise our allies and offer alternative solutions to courses of action that it was, frankly, a schoolboy error to pursue.
Afghanistan gained its independence from Great Britain. We learned the hard way, through three separate engagements over a century, that it is a deeply tribal country, where local loyalty trumps alliances to the centre. Policy cannot be shaped from outside the country. Since Ahmad Shah Durrani founded modern-day Afghanistan in the 1700s, it has not been run from the centre. Warlords enjoyed federated power; tribes and sub-tribes enjoyed autonomy. Why on earth did we, with all our experience of Afghanistan, believe we knew better?
In 2001, in our haste to seek retribution for 9/11, we lost our way. We allowed other agendas to blinker both our historical experience and current military doctrine, and that made a tough mission all the tougher. We ignored Afghanistan’s history, which we helped to shape, and believed that we could once again impose a western model of governance from scratch. The objective of hunting down and destroying al-Qaeda after 9/11 was widely supported, and it triggered NATO’s article 5 for the first time. That morphed into taking on the Taliban, who harboured al-Qaeda. This brings us back to that first rule of war: know your enemy.
To understand the Taliban and its origins, we must understand the mujaheddin; to understand the mujaheddin, we must understand the Soviet occupation; and to understand that occupation, we must understand that it was US foreign policy to remove the Soviets in the 1980s. That is wisdom not from history books, but from events in our lifetime. The last king, Zahir, was overthrown in 1973, and that triggered a power struggle between two diametrically opposed movements: the Communist party and the Islamist movement—the mujaheddin. Both grew in strength, with the former gaining the upper hand, but radical socialist changes sparked significant unrest, which the Soviets eventually sent in troops to try to quash. That prompted the United States, along with Inter-Services Intelligence in Pakistan, with support from China and indeed the United Kingdom, to support the mujaheddin—Charlie Wilson’s war.
From 1980 to 1989, £3 billion of covert military assistance went into east Asia to back a radical insurgency based in the Pakistani mountains. It mobilised tens of thousands of holy warriors who were willing to die for their cause. Out of the disunity of the mujaheddin rose the Taliban. It was not some distant extremist group that we knew little about, but arguably a product of western making.
Of course, the obstacles to success in Afghanistan were daunting: widespread corruption, intense grievances, Pakistani meddling and deep-rooted Afghan resistance to any foreign occupation. However, there was the colossal blanket of NATO security, and a huge development budget often described as an international aid juggernaut; US spending alone peaked in one year at $110 billion. Sadly, however, opportunities to secure long-term stability were squandered, and the west, especially the US, became over-confident following early victories.
In simple terms, where did it go wrong? First, we created an over-centralised model of governance. Secondly, we denied the Taliban a seat at the table in December  2001 at the Bonn talks. How different life would have been had they been included. Thirdly, we made no real effort to start training an Afghan indigenous security force until 2006. Fourthly, we opened up another front in Iraq—an unnecessary and costly distraction. Fifthly, we had no real development strategy to improve livelihoods and leverage the country’s vast resources.
I recall a visit to Afghanistan in 2008, when Mark Carleton-Smith, the current Chief of the General Staff, was in charge of 16 Air Assault Brigade. They took a turbine from Helmand—from Camp Bastion—to the Kajaki dam. A decade later, I flew into Kabul, and I looked out of the window and saw the same turbine lying next to the dam in its bubble wrap. That was analogous to the problems in that country.
Finally, we lost our way. We forgot why we were fighting and who we were fighting for. How could we claim that our intervention was about defending and upholding international standards and the rule of law when we crafted methods to bypass international law, such as creating detention camps, including at Guantanamo Bay?
For the first four years, Afghanistan was deceptively peaceful, as the Taliban retreated across the Pakistani border, but that time was squandered; the Taliban retrained, regrouped and rearmed. Slowly but progressively, they began their attacks, and by August 2009, General McChrystal observed, in his 60-page analysis, that we did not understand the people,
“whose needs, identities and grievances”
can differ “from valley to valley”; that the international security assistance force was “poorly configured” for counter-insurgency operations, designed instead for conventional warfare; that we were killing the enemy but not shielding the people; and that not enough was being done to train indigenous forces.
By 2014, Afghan forces were finally taking on more responsibility, and most NATO combat operations had ended, but still no formal talks had begun with the Taliban. Negotiations began in earnest in 2018, but when a deal was finally signed in February 2020, the agreement was between the United States and the Taliban; this time, the Afghan Government were not at the table. However, a US election was fast approaching, and the President, Donald Trump, wanted an announcement: “Bring our troops home.” Candidate Biden did not disagree.
The deal was done; all the Taliban had to do was wait for US troops to depart. The decision to withdraw was made, and we did not even have the courtesy to inform the Afghan forces when we departed camps such as Bagram air base. As the US forces withdrew, they took with them their contractors, who supported the Afghan forces. Of course, without ammunition, the Afghan army and the Afghan police cannot do their work. It did not take long for the Taliban to exploit the void and rout the country.
It is now clear to see what an operational and strategic blunder it was to retreat at this time. The Taliban are not a Government in waiting; they are not a monolithic organisation, so local reprisal attacks are taking place, which the Taliban themselves cannot control. As societal norms are removed, the banking system collapses and international support flees the country, we are seeing a terrible humanitarian disaster unfold. Once again, Afghanistan is a potential breeding ground for terrorism.
I noticed when I met the Taliban in Doha a couple of weeks ago just how frail they are. They say that because they are not enforcing such a ruthless interpretation of sharia law, many of them are leaving the ranks of the Taliban to join ISIS-K. That is what we have left behind. The decision to withdraw was absolutely the wrong call.
I end by looking at the wider consequences of our departure. What is the US’s commitment and staying power to defend the international rule of law? What of NATO’s function, with or without US lead? Twenty years since 9/11, are we still no better at preventing the radicalisation of individuals who believe they will be rewarded if they kill westerners? What next for those 40 million Afghans that we left behind? How do we work with the Taliban to prevent a humanitarian crisis? Finally, after this humiliation and retreat by the west, should the UK seek to play a more active role on the international stage?
I hope that our departure from Afghanistan is not the high tide mark of western post-world war two liberalism. We are seeing the erosion of western influence, the loss of faith in the idea of a liberal world order, and the rise of a rival superpower, China, which is advancing a competing ideology that could see the world splinter into two competing spheres of influence.
I encourage the Government to see the bigger picture—how on the one hand our world is becoming increasingly unstable, but on the other, the west, including Britain, has become more risk averse. We are in for a dangerous decade, and Britain should have more confidence in itself, in what we stand for, what we believe in and what we are willing to defend. As the last century illustrated, it was once in our DNA to do just that. We have the means, the hard power, the connections to lead. What we require is the backbone, the courage, the leadership to step forward.
I say directly to the Minister that cutting the defence budget last week sent the wrong signal about our commitment and our resolve. This is not the time to cut back on our troop numbers, our tank numbers and our plane and ship numbers, but that is exactly the consequence of what is happening. We have some serious questions to ask about our place in the world and what global Britain means, and that should begin with an inquiry into Afghanistan.

Jamie Stone: I commend the right hon. Member for Bournemouth East (Mr Ellwood) for that tremendous tour de force of what has happened over the last few years. I want to comment on some of the aspects that should be brought out in the inquiry, and to share with the House several other thoughts.
The sort of things that I would like to know are these. Others have asked before me, but I need to know: did the Prime Minister know what President Biden was planning before the withdrawal of American forces was announced? If so, was a risk assessment carried out? Only last month, there was a meeting of global leaders about Afghanistan. Macron was there, Merkel was there, Biden was there and Mr Trudeau was there, but the  Prime Minister was not. I regard that as unfortunate. As the right hon. Member for Bournemouth East indicated, in so many ways, as the catastrophe unfolded after we withdrew, it was absolutely predictable what would happen. Did the Prime Minister think the same at the time? I wonder.
I want to put on the record my and my party’s thanks, and I am sure those of everyone in the Chamber, for the sterling efforts made by the Secretary of State for Defence to secure evacuation of British and Afghan workers and civilians. I have personal cause to be grateful to the Secretary of State, but it seemed that No. 10 did not move to ensure some sort of EU involvement in Afghanistan to help secure that work after the US withdrew. I have touched before in this place on the actions of the then Foreign Secretary. I expressed my concern then and I will leave it at that.
Aside from an inquiry, one side point I want to make is that my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) has been calling for a corridor to get refugees out. There has not been so much talk of it of late in the press, but I fully support that, as I am sure we all do. I have friends who served in the armed forces who are still trying to get interpreters out. Good work has been done. I put on record my thanks for a second time to the Secretary of State for Defence, as well as to other Government Members who have been very helpful in securing people’s safety, but there is work to be done. We must not lose sight of the need for a safe corridor.
The scope of the inquiry has to be very wide. I utterly endorse what the right hon. Member for Bournemouth East said about the recent Budget. It was a tax and spend Budget—one with extra money. The 1.4% cut in defence spending over the next four years is deeply worrying. Several times I have expressed my concern at the cut in the size of the British Army. Perhaps the cut has ramifications for the other services as well—I know not. One thing I would like to see from the inquiry is an investigation into what assessment, prior or immediately prior to the intervention in 2001, was made of the military’s capability to intervene and maintain our defences at the level required. The hon. Member for North Wiltshire (James Gray) and I have mentioned that point several times. There are states out there, for example China, that are not there for the good of the United Kingdom. What assessment was made into whether we could do that?
Whatever the rights and wrongs of what was done—the inquiry will bring that out—where does it leave our standing as a military power, which I have just touched on with regard to the defence cuts, and as a soft power in the world? We are incredibly lucky that English is one of the great languages of the world. That, via our media—the BBC and so much else—gives us soft power that we can use. On a lighter note, it is astonishing how many people around the world watch “The Crown” of all things, but that demonstrates what we can do as a country. We lose that soft power at our very, very great peril.
The Government’s decisions, as the right hon. Member for Bournemouth East said, were too hasty. Yes, they were brought about in part by an American President and the candidate to succeed him, but things could have been done so much better and they were not. What does that leave, in terms of what is happening in Afghanistan? I shall rest that point there.
I want to end with an anecdote I always remember. As you know, Madam Deputy Speaker, I was a Member of another place. I do not mean the other place next door to here—that day will never happen—but that I was a Member of the Scottish Parliament. In 2009, the NATO conference took place in Edinburgh. In previous years, I had got to know the then Russian consul general in Edinburgh, Vladimir Malygin. One day his office called me to say, “The NATO conference is on. We have two serving Russian major generals in civvies who are observers at the conference and they would like to look around the Scottish Parliament. Could you organise it? Could you make it happen?” So we showed the two Russian generals, plus an interpreter, around the Scottish Parliament. The generals were taciturn individuals, but when we had finished the tour, I said, “Would you like a glass of whisky?” and they cheered up greatly at that prospect. What I will never forget is that while they were enjoying a drop of Scotland’s finest, they suddenly said to me, “What on earth are you doing in Afghanistan?” This was in 2009, eight years after we went in. One of them said, “I lost three of my best friends there. One was horribly mutilated.” That question—what were we doing there—has always stayed with me.
There is a space for the United Kingdom to do good in the world, provided we work out why we are doing it and, as the right hon. Member said, what our aim is. People in the armed forces I talk to say, “Identify your aim and be sure of it”. I will leave my comments there.

Stewart McDonald: I congratulate the right hon. Member for Bournemouth East (Mr Ellwood), the Chair of the Defence Committee, on securing the debate, and commend him for the leadership he has shown in the weeks and months since the withdrawal was undertaken.
It would perhaps seem strange if we did not acknowledge the acres of empty Benches around us. Less than three months ago, this House was recalled from its summer recess to discuss the very issue we are discussing now, and today we have started the wind-up speeches only minutes after the Chair of the Select Committee got to his feet. That worries me and speaks to the reason why we need the inquiry that he has come here to ask the Government to instigate—a case he prosecuted forensically.
The SNP supports the right hon. Gentleman’s call for an inquiry. I think he is right that it is important to those who served. It is important to their families. In particular, it is important for those who went to Afghanistan and paid with their lives, whether they were UK armed forces or those who served alongside them. It was fashionable at the time of the initial withdrawal not to acknowledge the international coalition, but I think we should. Above all, we owe it to the people of Afghanistan, not just those who have lost their lives or been maimed or injured over the course of the west’s time there, but those who now face the long dark night of Taliban rule that stretches out before them. Yes, that includes in particular women and girls, minority groups, journalists and academics, but also all who tasted freedom over the past few years and have now had it rather abruptly snatched away.
It is notable that although there have been some other inquiries in different coalition countries, it is only the Norwegians who have set up a fully independent inquiry.  That is something we need to do here. Yes, inquiries are expensive, necessarily so. Inquiries are slow, necessarily so. We have not had that many of them, necessarily so. But if the Government will not bring forward an inquiry on Afghanistan, then goodness knows what they will ever bring forward an inquiry on in future. They need to look at the long stretch of the mission, the motivation for why we went there in the first place, and the chaotic withdrawal, which we were recalled for less than three months ago.
I would like to put on record—the Minister and I exchanged on this last night—that I had actually thought this was a Ministry of Defence debate. As my party’s defence spokesperson, I wanted to put on record my thanks to the Defence Secretary for his conduct in the aftermath of the withdrawal. I do not think he and the Government got everything right, and the Foreign Secretary certainly did not, but I do not want to rehearse that this afternoon. It is important to acknowledge that the Defence Secretary seemed to be the only Minister who grasped the issue’s importance at the time—I will rephrase that: the only Cabinet Minister, because I do not want to be unfair on the Minister before us.
The right hon. Member for Bournemouth East touched on a broader point about political will and assessing exactly where we are with the implementation of our values. The Minister and I will disagree on much about defence and foreign policy, but fundamentally, our agreements are underwritten with the same kinds of values—on openness, tolerance and solving big issues in alliances with other countries.
I am a committed internationalist. Multilateral fora such as NATO and the European Union are, by a country mile, the best parts of the international architecture for advancing values of tolerance, liberal democracy and openness. If they did not exist, we would want to create them, and I would want Scotland to be in them and all the countries around us to be part of them. They are by the far the greatest vehicles for the kinds of values that we in this House all share. However, we must all reflect, and NATO at large must reflect, on this defeat—there is no other word for it. If there is a failure to do so and to have the kind of inquiry that the Chairman of the Defence Committee is asking the Government to initiate, those who want to overturn our values, as he mentioned, will take heart from that. Within hours, China was talking about the weakening of the west. Russia was in Kabul barely days after it had fallen, while we, in concert with others, were desperately scrambling—and failing in too many cases—to get people out quickly and alive.
Alongside an inquiry, the challenge is this: we must have a political discussion with other capitals that we are allied with about how we renew and reinvigorate the international architecture that underpins and drives the order that we have all benefited from and want to see us continue to benefit from. If we do not do that, who will benefit? It will be those who stand in opposition to our values. So the question is: what does Afghanistan and that withdrawal become? Does it become a low point for the liberal international order that we all believe in, or does it mark the point of no return? The Minister will have to answer that when he gets to his feet. If we do not have a full, independent inquiry, properly funded and properly prosecuted by a judge, with full powers of  subpoena and all the rest of it, I fear that this will be a point of return, and I am sure that nobody in this House wants that.
The right hon. Gentleman has the full backing of my party for his proposal for an inquiry. Let us not shrug this off this afternoon. The debate will now, necessarily, be depressingly short; perhaps the acres of empty green Benches scream out that we need the inquiry that he asks for.

Tobias Ellwood: I am grateful for the hon. Gentleman’s support. Is it worth his clarifying this point, which I did not? We have in our mind, as a yardstick, that an inquiry looks like Chilcot. Nobody is asking for Chilcot, but we are asking for something that I believe should be the norm: after every long-term military engagement, there is an assessment of what happened so that we can learn for the better. However, it does not need to take the legal approach that Chilcot was all about. That had a very different, complicated requirement.

Stewart McDonald: The right hon. Gentleman is absolutely right. I believe that the Defence Committee has started its investigation, and we on the Foreign Affairs Committee have started ours. Parliament has a role to play in doing its job and scrutinising what Government have and have not done, and making recommendations for the future. That is right and proper, but he rightly asks for something above that that can do the necessary job. I get entirely why Chilcot provides a rather unhelpful shadow over this discussion, but it cannot be used as an excuse to shrug off what the right hon. Gentleman asks us to do. This is up to the Government and up to us all. What we have shown through the lack of hon. Members’ presence in this debate is that Parliament cannot be left as the only institution to scrutinise the matter.

Jamie Stone: The hon. Member is making a most excellent speech. The point made by the right hon. Member for Bournemouth East (Mr Ellwood) was that, whatever the rights and wrongs, this place will sadly, from time to time, have to commit people to defend or fight, and the whole of the decision making from the Government or this place will be compromised and corroded unless we have a full inquiry that gets everything out in the open and that we learn from. I hope that this is a low point from which we rise again one day.

Stewart McDonald: Indeed. Can the hon. Gentleman imagine what a slap in the face it will be to those who put on the uniform so bravely—for whom we wear the poppy at this time of year—if we do not take the time to learn lessons, as the right hon. Member for Bournemouth East (Mr Ellwood) said we would be expected to after such an enormous military campaign?
Is this a low point or a point of no return? I hope that the Minister will tell us this afternoon that it is a low point from which we will learn—

Jamie Stone: A turning point.

Stewart McDonald: And turn—and even if the hon. Gentleman suggests that we rise again, I suggest that this should perhaps be something from which  we learn and get to what we really need, which is the  reinvigoration and assessment of what the liberal international order is actually for and how it will lead to change, as it is being contested and challenged like never before.

Stephen Kinnock: I thank the right hon. Member for Bournemouth East (Mr Ellwood) for securing this important debate and for his commitment and leadership as Chair of the Defence Committee. I also thank right hon. and hon. Members and their staff across the House for the hard work and professionalism that they have shown, given the tremendous difficulties that they have faced in getting their constituents, family members and other vulnerable people out of Afghanistan over the past few months. Parliamentarians and caseworkers alike can be enormously proud of their efforts, which have shown the House at its best.
Of course, the real heroes of Operation Pitting are the British and American servicemen and women, and those from other allied countries, who worked around the clock in unimaginably difficult circumstances to stand up for the values that we as a nation hold dear by evacuating British nationals, along with the brave Afghans who have supported UK operations in Afghanistan and who have stood up and campaigned for the values that we cherish and hold dear. We all saw the harrowing images from Kabul. It is clear that our country, and particularly our Government, owe those members of our armed services and our diplomatic corps a tremendous debt of gratitude for the work of not just the past few months, but the past 20 years.
The right hon. Gentleman made an eloquent case for the need for a wide-ranging inquiry into Britain’s role in Afghanistan. We agree with the principle of the need for an inquiry, but it is our firm view that the failures that need investigating are primarily those of political leadership that started with the Trump-Taliban Doha agreement. Let me set out why.
First, there is broad agreement that the decision for Britain to join the NATO-led and US-led invasion of Afghanistan was utterly just and right as a response to the most devastating and brutal terrorist attacks on liberal democracy in modern times. Those attacks killed 2,977 innocent civilians, including 67 British citizens, and we were right to defend our national security.
We must never underestimate the pivotal role that our armed forces played in ridding Afghanistan of al-Qaeda, in removing the Taliban from power and in succeeding in the hunt for Osama bin Laden. It can never be said enough that while there was a British presence in Afghanistan, there was not a single terrorist attack on the west from Afghan soil. That is a fine collective achievement of which we should be truly proud.
What our servicemen and women did kept the rest of us safe—it is as simple as that. They also gave Afghan women and girls a level of freedom, education and empowerment that they would never previously have imagined. Let it never be said by anyone that those British soldiers died in vain. We must be absolutely clear on their achievements and their contribution.
Secondly, reports by the Select Committee on Defence already cover in detail the events on the ground in Afghanistan prior to the Trump-Taliban Doha agreement; its fourth report, “Operations in Afghanistan”, has proved particularly valuable to gaining insight and learning  lessons. Of course, the armed forces may wish to undertake their own investigation into events to learn lessons from a military, operational and tactical perspective, but I believe that this House has a duty to focus on the political leadership and decision making that took place in the run-up to the Trump-Taliban Doha deal and afterwards, up to the present day.
Thirdly, the time and scale of an inquiry spanning 20 years would be almost unmanageable. I know that the right hon. Member for Bournemouth East said that we cannot use Chilcot as a yardstick, but the reality is that we are not clear on what other yardstick we would use, which is why Labour proposes a very defined scope, based on the milestone of the Trump-Taliban deal. The Chilcot inquiry into Iraq covered eight years of UK activity, beginning in the run-up to the invasion of Iraq; it took seven years to complete. If a similar model were applied to Afghanistan, an inquiry could take up to two decades to complete.
We cannot wait for two decades. Justice delayed is justice denied, so we must prioritise and use the time as effectively as possible. We know that removing the Taliban and defeating al-Qaeda was the right thing to do, but we know that the Doha agreement and events since have been utterly catastrophic, so let us focus on that important and in some ways deeply regrettable chapter in our history. We know that the Taliban are the root cause of the death and destruction that, unfortunately, has come to define Afghanistan since the 1990s, but we need to understand why they were able to defeat the Afghan army at such a shattering scale and pace.
What should the inquiry into the period from February 2020 onwards focus on specifically? Labour proposes the following. First, it must concentrate on learning the lessons from the Doha agreement up to 31 August. Why was there such a failure of diplomacy and of political leadership? Perhaps, on that point, the Minister can help me with a few of the questions that should certainly form part of the inquiry. We know that the Defence Secretary welcomed the Doha agreement between the Taliban and Donald Trump, but what did the UK Government know about that agreement ahead of time? The then Foreign Secretary said that
“we are following the negotiations”—[Official Report, 4 March 2021; Vol. 690, c. 415],
so clearly the UK Government were not at the table, but were Ministers even consulted on what was being discussed in Doha?
Despite our Prime Minister doing everything he could to cosy up to Donald Trump, it seems that our Government were left out in the cold. What does that say about the Prime Minister’s ability to build and maintain relationships with our key strategic defence and security partners?
Why were the Afghan Government not only locked out of the negotiating chamber, but completely blindsided by the result of the negotiations? Imagine an Afghan soldier on the ground in Afghanistan seeing the US sidelining their democratically elected Government to do a dirty deal with a misogynistic and murderous bunch of tyrants. No wonder morale collapsed in the Afghan army from that time onwards.
Did the UK Government challenge President Trump on his decision to fatally undermine the Afghan Government and military? We need to know what communications the UK had in the months before the  31 August withdrawal date and what concerns it expressed about the risks that UK and US forces faced.
On 20 April, Labour’s shadow Defence Secretary, my right hon. Friend the Member for Wentworth and Dearne (John Healey), told this House:
“Now, with the full withdrawal of NATO troops, it is hard to see a future without bloodier conflict, wider Taliban control, and greater jeopardy for those Afghanis who worked with the west and…women”.—[Official Report, 20 April 2021; Vol. 692, c. 853.]
Why were Ministers not listening to our shadow Defence Secretary? On 8 July, the Prime Minister said:
“I do not believe that the Taliban are guaranteed the kind of victory that we sometimes read about.”—[Official Report, 8 July 2021; Vol. 698, c. 1107.]
Complacency was rife. Naivety was rife. The consequences were tragic.
Why did the then Foreign Secretary ignore messages from the UK ambassador to Afghanistan, the courageous Laurie Bristow, that made it clear that the Taliban advance was imminent? Warnings began in early July, but the message of most significance came on 2 August, when the ambassador wrote:
“The gloves are off. We are entering a new, dangerous phase of the conflict.”
Previously, on 22 July, the principal risk report by the then Foreign Secretary’s own Department had warned of rapid Taliban advances. Why did he feel that the most appropriate response to those messages was to go on holiday and refuse to make vital calls to his counterparts in other countries?
Secondly, the inquiry should focus on the immediate aftermath of the withdrawal—the months that we are living through right now. Why have so many colleagues failed to get adequate responses from the Foreign Office and Home Office helplines on behalf of their constituents? How many more vulnerable Afghans do the Government have on their list of people who need to be supported to leave the country? Why is the Afghan citizens resettlement scheme still not open for applications? Is it because the Government actually have no intention of ever opening it for applications? Are they in effect pursuing an operation of tapping on the shoulder, rather than opening the scheme up for applications, because the response would be so overwhelming? If so, the Minister should inform the House. Transparency is vital in this matter—lives are at stake.
Have the Government done enough to engage regional powers such as Pakistan to secure safe passage for those who are attempting to flee? How can we ensure that we direct financial and humanitarian support directly to Afghan services such as hospitals and schools, so that we can bypass the illegitimate Taliban regime? What leverage do we have as a result of the frozen £10 billion of reserves that the Afghan Government would have had in the west? What should we be demanding from the Taliban? What conditions should we be insisting they fulfil in return for the unfreezing of those funds?
Finally, the inquiry must focus on understanding the full implications of the Afghanistan withdrawal for Britain’s place in the world, and how it might affect our defence, foreign policy and national security. The British Government’s actions over the past 18 months have not been befitting of a country that has always been an influential voice at the top table of global affairs and that rightly prides itself on being one of the world’s major military powers. We therefore need to know the  impact of the Taliban takeover and of the resurgence and insurgence of ISIS-K on the security of the British people.
What strategy are the Government putting in place to deal with terrorist threats from abroad, in Afghanistan and beyond? We need a laser-like focus on countering terrorism if we are to avoid a return to the days before 9/11.
What impact have the Conservative Government’s actions had on the reputation of Britain internationally, and the levels of trust between the UK and its allies, and how can we rebuild our reputation as an alliance maker rather than an alliance breaker? Are we still a country that is genuinely committed to defending the international rules-based order? Are we happy to see the world descend into anarchy? Will the UK be trusted to stand up for places such as Taiwan as China seeks to further its authoritarian influence?
Britain can still look forward to being a proud internationalist country with a proud internationalist future, but this isolationist Conservative Government appear to be intent on diminishing our great nation and diminishing the alliances that are so important to the status and the voice that we have. We therefore commend the right hon. Member for Bournemouth East for his call for an inquiry, while urging him to look at the possibility of narrowing its scope in terms of the specific timeframe that we are discussing, because we believe that that is the best way to hold accountable those who should be held to account, and to ensure that we use all our resources as effectively as possible, because justice delayed is justice denied.

James Cleverly: I am grateful to my right hon. and gallant Friend the Member for Bournemouth East (Mr Ellwood) for securing the debate, and I pay tribute to his long-standing commitment to Afghanistan, including what he has done in his current role as Chair of the Defence Committee. I am also grateful for the thoughtful contributions from other Members, including the hon. Members for Caithness, Sutherland and Easter Ross (Jamie Stone) and for Glasgow South (Stewart Malcolm McDonald) and, indeed, the shadow Minister, the hon. Member for Aberavon (Stephen Kinnock). It is my pleasure to respond on behalf of the Government.
Before I do so, however, I want to record my thanks to all British service personnel who were deployed to Afghanistan over the course of our commitment there, and also to the countless diplomats, development experts and others who served there out of uniform. I want to thank our allies, and I very much want to thank the brave Afghans who worked shoulder to shoulder with us all over the last 20 years.
As a result of our collective efforts and those of our international and Afghan allies—as the hon. Member for Aberavon pointed out—no major terrorist attacks against the UK or, indeed, any NATO country have emanated from Afghanistan over the last 20 years, and that is something for which we should rightly be grateful. As a result of our efforts and those of our allies, secondary school enrolment rose from 13% of children to almost 60%. Over 8 million more children, including 3.6 million girls, were attending school than in 2001.  Basic health services reached 85% of the population, and the proportion of people with access to clean water and sanitation doubled. As a result of our efforts and those of our allies, life expectancy rose by an incredible eight years. Over those 20 years, maternal mortality nearly halved, and infant mortality decreased faster than in any other low-income country. In short, our efforts over 20 years made the UK safer, and gave Afghans health, education and a degree of hope. Those achievements should be a matter of great pride to us all, and our focus now is on protecting them.
My right hon. and gallant Friend focused very much on the NATO mission. NATO allies went into Afghanistan together, and they left together. The 11 September attacks were the only occasion in NATO’s history on which it has invoked article 5, its collective “self-defence clause”. The UK played an active role in NATO collective decision making throughout the mission, and that includes the collective NATO ministerial decision on 14 April this year that NATO troops could not stay without American forces.
Since mid-August, we face a new situation, but we have enduring interests, and a continuing commitment to the Afghan people. Today, we have four major objectives. They are, first, to preserve the counter-terrorism gains that we have achieved, and ensure that Afghanistan does not again become a source of threats to the region or beyond, including here in the UK; secondly, to provide humanitarian support for the Afghan people, who are facing extreme hardship—42% of the population, more than 18 million people, are suffering crisis or emergency levels of severe acute malnutrition; thirdly, to press for inclusive politics and respect for human rights, especially the full and equal rights of girls to go to school and women to go to work; and finally, to ensure that the events in Afghanistan do not destabilise the region, for example, through uncontrolled outflows of refugees or the export of narcotics.
Through our presidency of the G7, our role in the Security Council and the G20, and our partnerships with countries in the region, we have helped to build global support for those four goals, and—just as important—we will continue to assist British nationals and eligible Afghans who are trying to relocate from that country. To pursue those goals, we need to have pragmatic engagement with the Taliban. Officials have had a number of meetings with the Taliban leadership since August, for instance, during a visit to Kabul by Sir Simon Gass, the Prime Minister’s High Representative, and meetings with the Taliban hosted in Doha. Thanks to those exchanges, the Taliban are clear about the fact that the eyes of the world are upon them and we are watching their actions closely. They know what they must do if we are to co-operate. That includes allowing girls to go back to secondary school and women to go back to their jobs, and preventing the movement of foreign terrorist fighters.
We are also offering practical support to Afghans, without benefiting the Taliban. The Prime Minister has said that we will double humanitarian and development assistance for Afghanistan this year, to £286 million. On 31 October, he announced the allocation of £50 million of that to fund emergency humanitarian support. The money will help to provide 2.5 million people with life-saving healthcare, food security, and shelter. We are working with other donors and the World Bank to  continue the provision of basic services for the Afghan people, through non-state-run channels. Strong primary healthcare is vital if we are to protect Afghan women and children.
My right hon. and gallant Friend has argued that we must learn lessons from the NATO mission, from our broader campaign and from the way that it ended. He is, of course, right. We must, and we will. Our main focus right now is on ensuring safe passage for anyone remaining in Afghanistan who needs to leave, supporting the thousands of new arrivals in the UK, and continuing to provide assistance for the Afghan people who remain in Afghanistan—but, of course, we are always learning lessons: learning lessons from Afghanistan has been a continuous process. That is why, after the conclusion of Operation Herrick in 2014, the Army conducted a thorough internal review. We also incorporated lessons from that in the integrated review that we published earlier this year. Departments are undertaking their own Afghanistan lessons learnt exercises in their areas of expertise and contributing to NATO’s lessons learnt exercise, all of which will inform our defence strategy and future UK military operations.
In addition, the Government welcome the inquiries of this House’s Foreign Affairs Committee and of my right hon. Friend’s own Defence Committee. We welcome the debates in the House and the interest of the Intelligence Security Committee, the International Development Committee, the Home Affairs Committee and the Joint Committee on National Security Strategy, among others.

Stewart McDonald: As a member of the Foreign Affairs Committee, I can tell the House that we are proceeding with our inquiry on this. However, I submitted a number of written questions to the Minister’s Department when the previous Foreign Secretary was still in post. I do not want this to come across as personalised, but it is important for Parliament to understand what Ministers were and were not doing during the month of August. There has been a lot of public debate, particularly about the Foreign Secretary’s movements and actions. I submitted a whole series of questions asking for ministerial engagements on each of the days on which the Taliban were advancing across more and more of the country. The Foreign Office will not give me answers to those questions, so how is Parliament supposed to have any confidence that the Government take Parliament’s inquiry seriously when we cannot even get basic things such as call logs to tell us who Ministers were talking to as the Taliban were getting Kabul ever closer in their sights?

James Cleverly: The Foreign, Commonwealth and Development Office takes very seriously the inquiries from Members from every part of the House, and we seek to answer them in a way that informs Members without compromising security or, sometimes, the discreet work that the Department has to do.
The simple fact is that multiple inquiries are being conducted by the Committees of the House into the functions of the Government. Indeed, my right hon. Friend the Member for Bournemouth East is leading the inquiry by the Defence Committee that will cover what happened after the US agreement with the Taliban in February 2020—the exact period of time that the  hon. Member for Glasgow South mentions. It will also cover the planning and execution of the withdrawal of UK forces and the evacuation of UK nationals and Afghanistan nationals who worked with the British armed forces.
The Government’s view is that these initiatives offer ample scope to address the most important questions. The hon. Member for Aberavon, who knows that I have a huge degree of respect for him, has suggested a more limited inquiry—one that would be limited to a timescale that would prevent it from looking at the role his party might have played when it was in government. While the final stages of the deployment are important, if his proposal were to be taken forward, I think that people might see it as partisan and cynical. As the Prime Minister told the House on 8 July, we do not think an inquiry in addition to those multiple other inquiries is the right way forward.

Stephen Kinnock: I thank the Minister for giving way; he is being very generous. Just to be clear, what I said in my remarks was that there had already been multiple inquiries into the Afghan intervention preceding 2010—some by the Defence Committee. He himself is commending the work of the Defence Committee in making inquiries. We are saying that it is important to prioritise and that we need something that does not take a massive amount of time, as Chilcot did. We are saying this in a genuine spirit of bipartisanship; I am certainly not attempting to be cynical or party political in any way.

James Cleverly: I will take the hon. Gentleman at his word. Being an honourable Member is not just some loose title; he is genuinely an honourable gentleman and I take him at his word.
The Government welcome the close interest in these events that the House has taken. We will study recommendations of the inquiries by the Foreign Affairs Committee, the Defence Committee and others with great care. The military campaign in Afghanistan over the past 20 years claimed the lives of 457 British service personnel, but we must never forget that it saved the lives of countless others. We can be proud of what we achieved, in step with our NATO allies, and today we are doing everything we can with our partners to protect those gains, to ensure the UK’s security and to help the Afghan people in their time of greatest need.

Rosie Winterton: I call Tobias Ellwood to wind up the debate.

Tobias Ellwood: I am grateful for all the contributions that have been made today on this important issue. I am also grateful to the Minister, who has worn the uniform and who I know takes these matters very seriously indeed. However, we have raised more questions than we have had answers to, which is exactly why we need an inquiry. I believe that there should be a default position that whenever this country goes to war or is involved in a long-term conflict, there should be some form of formal wash-up provided by the Government. If I had a private Member’s Bill opportunity, I would put one forward, but I would be worried that the Government would whip against it and that it would not get through. That is another matter, however.
The Minister talked about terrorist attacks from Afghanistan, and he was absolutely right, but we are no longer there so that threat is now very much back on the cards. The humanitarian assistance was significant, but it has been diminished because we have decided to depart. On NATO, he was right to say that there was an all in, all out approach, but that did not anticipate Donald Trump coming very close to taking the United States out of NATO. That was not the way forward that anybody imagined.

Stewart McDonald: Will the right hon. Gentleman give way?

Tobias Ellwood: I am not sure. With the indulgence of the Deputy Speaker, I would be happy to give way. I seek her guidance.

Rosie Winterton: The right hon. Gentleman is winding up the debate.

Tobias Ellwood: Okay, I will continue. I will conclude the debate, because I know another one is following this one.
I would argue that if there were a free vote on whether we should have an inquiry, many Members of this House—particularly Conservatives, but also Members from all parts of the House—would support it. It is the right thing to do. There is work to be done on the special relationship, and we need to show that we understand the world and that we can offer alternative points of view. We will be asked to do something similar in the future, potentially in Mali, Yemen, Lebanon or Afghanistan. A Kurdistan area could develop north of the Hindu Kush, because the Taliban are not in control of the whole country. The music has not stopped there, and resistance will build up in the next couple of years. We need to understand how we can do things better and understand the political decision making that went on.
My final words are to the brave people who served and to the bereaved who still miss the loved ones who did not return. They are scratching their heads—we know that because we have talked to them—and wondering what on earth it was all for. I spoke to the Taliban in Doha, and they know that the societal change that we introduced over 20 years is too much for them to reverse. The country has moved on, and it is too large. It is demanding too many new, modernised things for the Taliban to turn back. If there is a modicum of justice there, it is that we have advanced the country a long way forward. It has been handed over to the Taliban, but the spirit of what is now there in Afghanistan will be bigger than anything the Taliban can do to undo it and turn it back to what we saw in the 1990s. We can say thank you to our troops for achieving that.
Question put and agreed to.
Resolved,
That this House has considered the proposal for an inquiry into the UK’s involvement in the NATO-led mission to Afghanistan.

Medical Cannabis: Alleviation of  Health Conditions

Ronnie Cowan: I beg to move,
That this House has considered the matter of the use of medical cannabis for the alleviation of health conditions.
I would like to start by paying tribute to the mums and dads, brothers and sisters, grandparents, guardians, extended families and friends who have campaigned diligently, respectfully and passionately to bring about the reform in access to medical cannabis that they so desperately desire. Many are full-time carers, with all the pressure and time constraints that that entails, yet they have found the time and the commitment to energise a campaign—a campaign that far too many politicians and medical professionals have turned a blind eye to.
I would like to thank the Backbench Business Committee for supporting me in bringing this debate forward today. I would also like to thank those Members who have reorganised their diaries and travelling arrangements to be here today. There are a number of MPs who would normally be here today to debate a subject that is close to their hearts, but for a variety of reasons, not least COP26, they are not. I guarantee they would all support any move by this Government to make it easier to access or research medical cannabis. I have never heard any MP argue against those objectives. There is confusion about drugs in general, which tempers some people’s desire to speak out, but the provision of medicine to sick people is not an issue.

Catherine West: I congratulate the hon. Gentleman on securing cross-party support for this debate. On research, does he agree it is encouraging to see the potential curative effects of various elements of this drug, as we call it, in treating very serious forms of epilepsy?

Ronnie Cowan: It is great to see that research has now been undertaken, and I have a list of five or six projects looking at medical cannabis across a range of different medical conditions, but there is still the issue that many academic organisations cannot get access to the cannabis or hemp plants they require because they are graded as category 2, which keeps the plants out of their hands. The paperwork and processes they have to go through to access the raw product are prohibitive, and recategorisation from category 2 to category 4 would aid the research of a host of academic establishments.
Why are we not making it easier for people to access medical cannabis? Why are people who would benefit from medicine derived from the hemp plant being denied that opportunity? Why can some medicines be purchased on private prescription only? Why are we not making medicines that are widely available in other countries available in the United Kingdom?

Margaret Greenwood: I congratulate the hon. Gentleman on securing this debate. He is making some important points. One of my constituents lives with progressive myelopathy of uncertain cause that affects his mobility and causes him to suffer brain fog, exhaustion and almost constant pain, which he has described as feeling like “hot wires” being pulled through  muscles and skin. Does the hon. Gentleman agree there is real urgency to this issue because of people like my constituent who are suffering on a daily basis?

Ronnie Cowan: Of course I agree, and I understand the difficulty in which the Government find themselves, particularly the Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), who is new in post. We need solid research that proves the efficacy of medicines, but behind that we have people who are living with these extreme conditions, day in, day out, for an awfully long time. We have been slow to get to this stage, so there is every reason why the Government should accelerate the research in such cases.
Over the last week or so I have met representatives from the Multiple Sclerosis Society and End Our Pain, and over the years I have heard representations from a much wider range of organisations and individuals that see medical cannabis as at least part of the solution to their or other people’s health issues. There are two licensed cannabis medicines, Epidiolex and Sativex, which are both made by GW Pharmaceuticals. There is nothing wrong with these medicines, but they are isolates, or very nearly, and isolates simply do not work as well as full spectrum products, and they have more side effects.
A full spectrum cannabis product contains all the different cannabinoids and terpenes found in that strain, whereas an isolate product contains only one chemical, such as cannabidiol in Epidiolex. There is published evidence that the full spectrum products are twice as good as the licensed Epidiolex in the treatment of seizures.
Then there are the unlicensed cannabis products that account for virtually all privately prescribed products. Unlicensed products are not routinely prescribed by NHS clinicians, but they can be prescribed by a specialist doctor on the General Medical Council’s specialist register. There are now about 10,000 private prescriptions, 60% for pain, 30% for anxiety and similar conditions such as post-traumatic stress disorder, and 10% for other conditions including neurological conditions, such as epilepsy and MS, and some cancer and gastrointestinal disorders such as Crohn’s. It is clear that medical cannabis can aid a wide range of conditions.
All imported products are imported because the Home Office has been slow in granting cultivation licences for high-THC plants in the United Kingdom, and matters are made worse by the cumbersome import process. Three years and three months after the current Secretary of State for Health and Social Care, while he was Home Secretary, changed the law to allow prescriptions for medical cannabis, we still have only three NHS prescriptions.
As I mentioned in yesterday’s Westminster Hall debate, and it is worth repeating, Hannah Deacon, whose son Alfie is in receipt of one of those NHS prescriptions, has written to the Health Secretary three times to ask him to help, as he promised her he would in writing when he was Home Secretary, but all three letters have been ignored. Why, three years and three months later, are there so few NHS prescriptions?
Basically, doctors are not trained in cannabis medicine, although several teaching programmes are now available. However, the main barrier is the rather unhelpful guidance produced by the National Institute for Health and Care  Excellence, which has looked at cannabis as if it were a pharmaceutical product, but it is not. We need better guidance written by people who understand the plant, not by those who understand only pharmaceutical medicine.
We also need acceptance of the validity of real-world evidence. The British Paediatric Neurology Association recently reviewed its guidance on prescribing medical cannabis in cases of intractable epilepsy, about which I have a number of serious concerns. If a family go ahead with a private prescription for medical cannabis, the guidance appears to say that the NHS paediatric consultant should insist that the private paediatric consultant takes on 24/7 care.
I am extremely concerned that this is a further attempt to make private prescribing so burdensome as to deter private prescribers. No private prescriber will have the infrastructure to provide this level of wraparound care. My concerns are further increased as this appears to have happened to one family already, and I have a letter supporting my concerns. I am pretty sure that washing their hands of patients in this way is not legal. Will the Minister immediately examine this issue and seek clarification from the BPNA that this is not the interpretation, and will she insist that the guidance is removed or changed?
Many barriers would be broken if general practitioners were allowed to prescribe, and a recent survey shows that a quarter of GPs would be happy to do so. That would require a simple change of the necessary statutory instrument under the Misuse of Drugs Regulations 2001 and would not require parliamentary time. I notice that, as of today, a leading UK insurer is now offering insurance cover at rates not dissimilar to normal cover for doctors prescribing medical cannabis.
To make this easier, there should be a focus on where the evidence lies for prescribing indication-specific, medicalised, pharmaceutical-grade cannabis. We must build on the legitimacy and efficacy of these medicines through the implementation of structured approaches to prescribing, which would help the UK healthcare system to be more inclined to prescribe cannabis sensibly.
In our debates in this place on refusing access to immigrants, health and safety in the workplace, poverty and welfare, I have heard the question many times: “Does somebody have to die before we take action?” Well, people are dying and people are living in unnecessary pain and discomfort.
I have four questions for the Minister. Will the Government recognise the value of real-world evidence, such as the research of Drug Science—including Project Twenty21—as proof of the efficacy of medical cannabis and stop insisting on randomised controlled trials, which are particularly unsuitable for rare forms of epilepsy in children? Do the Government have any plans to conduct a health economics analysis to investigate the cost-effectiveness of medical cannabis? Will the Government meet the costs of prescriptions for children requiring Bedrocan’s Bedrolite or similar products? And if a child was suffering from an epileptic seizure and the Minister had the medicine in her hands, would she administer it? I am sure the answer to the last question is yes, so will she please help to put that medicine into the hands of those who care for these children?
Finally, access to medical cannabis will someday be the norm. We need to confront the obstacles that exist today and clear the path for better access tomorrow.

Crispin Blunt: I am delighted to follow the hon. Member for Inverclyde (Ronnie Cowan) and have worked with him actively in the past few years on this issue, and I wish we had made more progress. I am delighted to welcome the Minister to her place, answering this debate. I have an interest recorded in the Register of Members’ Financial Interests on this, but it is a non-financial interest. It is in recognition of the fact that I chair an organisation that I have set up, the Conservative Drug Policy Reform Group Ltd, whose objective is to find the resources to bring arguments based on science and research into this debate, on all of drugs policy, and to have this academically peer-reviewed, so that the arguments for the huge challenge of a policy change that is required can be put in a proper, calm way, based on all the available evidence and a proper scientific assessment of that evidence.
I say to the Minister at the beginning of my remarks that this issue is not just about medicine from cannabis. That is one element and one casualty of how we have conducted our nation’s drug policy over the past five or six decades, but it is a huge missed opportunity. My journey into this issue arose as prisons Minister, when I saw the impact of taking a criminal justice approach to drug misuse as the first lever, rather than a public health approach. As I saw at first hand, the cost to the criminal justice system is just enormous. Indeed, the Government’s own statistics talk of a cost in the order of £19 billion a year. When one then thinks that half of acquisitive crime in the UK is driven by drug misuse and drug addiction, we see that we should be asking some serious questions about the whole of our drugs policy.
However, that is a separate debate. It was made clear to me when I became the first Conservative to co-chair the all-party group on drug policy reform, when I decided to make this issue one of my central areas of focus, after I ceased to be chair of the Select Committee on Foreign Affairs, that we needed to focus on the arguments for medicine, which had not been able to be researched and developed because of our drugs policy. Focusing on the arguments associated with prohibition and criminal justice, and the parallels with alcohol in the United States in the 1920s and 1930s, is not where the discussion is; the Government are completely clear on where their policy sits on those issues. There is now a big global debate on those issues, with a Global Commission on Drug Policy reform, but it was put to me that we must focus on getting medicines from cannabis for the people who are suffering because they are not able to get access to it.
I became co-chair of the all-party group in September 2017 and I took the advice I was given by people who had been in this field rather longer than I had, and we got behind the family of Alfie Dingley. A national newspaper had got involved and a petition was signed by 300,000 people. The family had gone to a holiday camp in Holland in order to access medicine from cannabis, because they could not get it in the UK. The Bedrocan oil that Alfie was getting then stopped his epileptic fits, but the family had run out of money, so they had to come back to the UK and they could not access the medicine here. On the day of the presentation of the petition to Downing Street, I was able to ask an urgent question in the House on the matter. The issue was raised with Ministers and we were given assurances  that the Dingley family were going to be helped to find their way through the complicated licensing process in order to enable Alfie to be able to access the medicine. Three months later, of course, they still had not got it. The cost of the licence application process—simply buying the licences to access this oil—was £20,000; we are talking about £5,000 a licence, so enormous barriers were put in the way.
Then we had the case of Charlotte Caldwell and her epileptic son Billy, who had been in the United States getting treatment. When they returned to the UK, wisely doing so via Dublin, because she lived in Northern Ireland, her GP gave her a prescription for the medicine she had brought back from the US. When the manufacturer of that medicine changed and it became a Canadian company, she needed a new prescription, at which point it all fell apart. The doctor was told, “You are not allowed to prescribe that medicine for this epileptic child to stop him having his fits.” With the support of Richard Branson and others, Charlotte went to Canada, collected the medicine, came back and presented it to customs at Heathrow on the Monday, when it was confiscated. By the Thursday the boy was in hospital fitting, and his consultants were on the steps of the hospital saying, “It really doesn’t matter. What is unacceptably cruel is to take a medicine that is working off a child.” The current Health Secretary, to his huge credit, then issued a special licence for Billy Caldwell to be able to get his medicine back from customs. That led to the then chief medical officer being invited to offer an opinion as to whether there was anything in this cannabis stuff as far as medicine is concerned. It only took her two weeks to come back with a strongly affirmative answer, based on the evidence available around the world. That then led to the regulations that the Government passed in November 2018, which have not solved the issue. As the hon. Member for Inverclyde said, only three prescriptions have been made on the NHS.
You will be familiar, Madam Deputy Speaker, as we all are in our constituencies, with the position of multiple sclerosis sufferers. There are about 50,000 people in this country growing their own medicine. They are committing quite a serious criminal offence in the process, but they are trying to treat their health condition. What we have failed to do on the back of the regulations passed in November 2018 is get an evidence-based approach to medicine from cannabis, and educate the health service, prescribing doctors and the rest about the potential benefits and how we should have developed a position from the first go at the regulatory change in 2018.

Julian Lewis: My hon. Friend is making a fascinating case, because I, like many other Members of the House, I am sure, thought that this problem had largely been solved. Why does he think it is that the Government or the Department find it is so difficult to grip this? I recall having back surgery 35 years ago and being very grateful for some pain relief. I asked whether I could have some more, but I was told, “No, you can’t, because it is morphia. It is related to heroin and you might get addicted.” If it was possible properly to prescribe something related to heroin for a proper medical condition 35 years ago, why can something similar by way of the arrangements needed not be sorted out for this particular problem?

Crispin Blunt: My right hon. Friend has alighted on a huge area of interest, which is pain control, not least end-of-life pain management. On the difference between opiate-based medicines, which he had, and cannabis-based medicines, the evidence is now all over the place about how much better the latter are, because people do not then have the addiction issues of the opiate-based medicines and they are not knocked out with what is, in effect, a chemical cosh towards the end of their life. They retain much better control of their faculties. They can enjoy a much better quality of life, even where they are being managed in terminal care, let alone where they are managing pain when they are not terminally ill. That is part of a missed opportunity. We are missing a huge bioscience opportunity for the United Kingdom because we have not got the regulations right, or their implementation has meant that these medicines have not begun to find the place they deserve in the pharmacopoeia and among the treatments available to doctors.
Of course, the private sector has stepped in where the NHS has not, and has used the special licence arrangements in the 2018 regulations, so we now have a two-track system. There have been three prescriptions on the NHS, but if someone has the means, they can pay roughly £2,000 a month for cannabis-based prescriptions. People can access cannabis-based medicines if they are prepared to go private and pay for it. That is an assault on the fundamental provisions of the national health service. Desperate parents of seriously ill epileptic children have moved countries to try to access this vital medicine. Of course, we will not know, because they will not tell us, how many have taken the illicit route and got their medicine from criminal sources. No parent or patient should face a prison sentence for treating a medical condition, and prioritising their health and the interests of those for whom they care and provide.
Access to healthcare in our country is, in principle, free at the point of use. Three years into the current system, that ought to be the case for medical cannabis as well. We should have made much more progress. The NHS’s own report on barriers to accessing cannabis-based medicine highlights the stark inequalities in, and problems with, the current regime. Although progress has been made on some preliminary fronts since the publication of that report, the most important outcome—appropriate, risk-based access to these medicines on the NHS—has simply not happened. We are being held back for a combination of reasons, including the risk aversion of a medical profession that is untutored and untaught in respect of the benefits—the endocannabinoid system does not appear in the syllabus for medical students—so the opportunity to have a cadre of doctors with the expertise to prescribe cannabis-based medicines now sits wholly in the private sector, and that expertise is available only at great expense.
This is not just about children with epilepsy, although they are of course the point of the spear, and everyone has huge empathy for them. Huge credit goes to End Our Pain, which got behind the Dingley family and put together the initial petition that got the issue into the public consciousness. That, combined with the Caldwell family, then got us formally over the line. I thought, as my right hon. Friend the Member for New Forest East (Dr Lewis) did, that this was done; but it was not. That is the tragedy: we have built up expectations. Out there in our constituencies, people have legitimate expectations  that they can now get this medicine legally—that they do not have to criminally grow it or go to a drug dealer and get God knows what, because trading standards do not exactly apply to the supply of medicine that is criminally delivered.
Behind those children with epilepsy—our hearts go out to the families, and I give them huge credit for the effort they put into the campaign, along with the people from End Our Pain and the associated parliamentary group—there are tens of thousands of people with multiple sclerosis and chronic pain who could, by now, be benefiting from this medicine. The Government have gone to great lengths to try to address the issue of the epileptic children. I pay tribute to the Minister’s predecessor, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), for all the time and passion that she put into engaging with this issue, meeting colleagues who represent epileptic children and getting into the detail of the prescribing barriers and the difficulty of moving cannabis-based medicines across international frontiers.
The Department of Health and Social Care also has to work through the Home Office regulations, which is not easy. If a Minister finds it difficult to enable medicines to be got to children who desperately need them, imagine how difficult it is for everybody else. I have huge confidence in the Minister, my hon. Friend the Member for Lewes (Maria Caulfield), who has empathy and understanding from her service as a nurse. She faces the challenge of having to grasp this complex issue.
The basis of the problem arose more than half a century ago. When cannabis was banned in the United States and then globally under the 1961 convention on drugs, it was put in the most restricted category of all for a reason that should shock and shame us: because 1950s American law enforcement thought that the principal users of cannabis were black Americans, so “It must be absolutely frightful. There can’t be any benefit in this.” Subsequently, cannabis found itself in schedule 1 of the Misuse of Drugs Regulations 2001, which made research almost impossibly expensive. That was utter madness, because the harms associated with cannabis-based medicines are fleeting and it is difficult to find evidence of them. That should be set alongside the potential benefits of treatments that ought to be available to people.
This research vacuum has meant that the Government are caught in a complex situation, and regulators are understandably highly risk-averse. We do not have the necessary skills, understanding or expertise among the medicine and health regulators who currently advise the Government. The medical and research community and the regulatory community are having to play catch-up because of the barriers that we politicians put in place in respect of a policy that has been around for more than 60 years.
Let me suggest to the Minister how we can move this issue forward, do our duty and serve UK citizens who find themselves in the wretched position of having to self-treat their conditions criminally because they cannot access the medicine otherwise. The public expect us to support them, and do not want sick individuals to be prosecuted for trying to obtain a medicine; that is where all registered public opinion sits.
My first suggestion is, of course, on funding for the epileptic children with the most serious conditions. There are so few of them, but the British Paediatric Neurology Association suggested that neurologists assess  the parents’ finances before issuing a private prescription, lest they be unable to pay for treatment in future. Is that really the place where we want to be? It is inappropriate and impractical for doctors to make assessments of their patients’ financial circumstances because those patients have been driven into the private sector.
The issue has to do with the public stigma around the word “cannabis”, but that is utterly unrelated to any assessment of the evidence of risk. We have to take ourselves away from coming to a view having seen that word. That is no way for those of us to proceed who are charged with responsibility for legislating, for regulating, and for serving our citizens. If we put our reputation ahead of the evidence and what we ought to enable for our citizens, shame on us.
In the case of Orkambi for cystic fibrosis, my right hon. Friend the Member for West Suffolk (Matt Hancock) and his predecessor, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), were prepared to go the extra mile to find different routes to enabling the use of that drug through a managed access agreement. That shows that we can find creative solutions in this space if we are prepared to look for them. I urge the Government to return to this issue in a creative frame of mind to find a solution that will work.
Sitting behind this is the claim that we are a bioscience leader. Cannabis-based medicines should be part of that bioscience development. In the United Kingdom, another set of drugs—psychedelic-class drugs—suffer from similar problems. Some $6 billion has been invested in companies in north America to develop what is seen as the next leap forward in mental health treatment for addiction, trauma and depression. That sum is completely explicable if one considers the scale of those mental health conditions. If we are on the verge of enabling psychotherapy to work effectively for the people with the most difficult and challenging conditions, it is no wonder that the financial markets found $6 billion to invest in that—but by and large, they are not investing in it here, and this nation is a bioscience leader.
It is the experience of many prescribers of medical cannabis and their patients that medicines that contain additional cannabinoids—not just tetrahydrocannabinol and cannabidiol—are the most effective. As a result, children with treatment-resistant epilepsy are benefiting from prescription of those cannabis-based medicines, although largely privately. However, the manufacturers have struggled to respond to the calls for research from the National Institute for Health Research. The NIHR must engage with manufacturers more directly and, again, more imaginatively, and provide sufficient support and detail to help them through the regulatory minefield and over the regulatory barriers that are stopping the delivery of these medicines.
The fact that the research is so immature is a direct consequence of the blanket censorship of scientific inquiry around cannabis, because the attitude to it was formed, racistly, on the basis of who used it illegally. There was no regard to the evidence on cannabis. It is the same with the psychedelic class of medicines. There is very little evidence of risk, or of deaths arising from the misuse of these medicines in their pure form, and we have perhaps put mental health treatment back five decades by not investing in, and exploring, these medicines in the way that their risk deserved.
We must learn lessons from the way that the policy developed in the lead-up to the November 2018 regulations, which failed to deliver the reform and change that we seek in order to treat sick, epileptic children, and those with so many other conditions.
I offer my hon. Friend the Minister the solution, and I hope that she will take it up. I am conservative in the proper sense—in terms of machinery of Government changes, and in terms of uprooting public administration and then replanting it to solve a problem. However, we are in desperate need of an office for drug control to enable all the interested Departments to take counsel together in Government. When the business is led by the Home Office, we find that its job is to protect the nation and to stop things happening. It has certainly succeeded in that, as far as research is concerned. It is the former Home Secretary, now the Health and Social Care Secretary, who opened up progress on this. I have great hopes that we will push on with this when it is on the health agenda, as well as the science agenda, and the agendas of the Department for Business, Energy and Industrial Strategy and, given the amounts of money being invested, the Treasury. [Interruption.] I am not sure about the level of demand for this debate, Madam Deputy Speaker. I appreciate that everyone would like to get away as soon as they reasonably can.
I am passionate about this, because we can do some real good here. If we push forward with creating an office for drug control, we will bring together all the interests in making progress in this area—for example, the Department for Environment, Food and Rural Affairs with regard to the growing of hemp in the United Kingdom. One begins to see a picture of how some Departments that Carol Black did not mention in her review as engaging in the treatment of those suffering from drug misuse still ought to be involved in the whole drug policy conversation. Opportunities for treatment and for better healthcare are being missed, quite apart from the economic opportunities that should be available for the nation.
Mr Deputy Speaker, I know that you want me to bring my remarks to a close. NHS England and NHS Improvement were tasked in 2019 with designing clinical trials appropriate for children who, in many cases, have made significant improvements and cannot ethically have their treatment withdrawn as would be required in a standard randomised control trial. We can and we must be flexible. The urgency of enabling timely access to medicines for these children was made clear, but it has not happened. These trials must happen and must present a route to access.
Sitting behind that are children who naturally tug  at our heartstrings, given their conditions and the extraordinary cornucopia of steroid treatment and everything else that has been thrown at them. They deserve our sympathy. Behind them sit tens, hundreds and possibly millions of our fellow citizens who can also benefit if we get the bioscience, the research and the regulatory framework right. I look forward to conversations with my hon. Friend the Minister as we go forward. I recognise her need and that of her fellow Ministers in the Health and Social Care Department to make sure that the advice of the regulatory agencies that advise them is properly taken. In the first instance, though, those regulatory agencies require the right expertise,  knowledge and understanding, and they need to  acquire it in order to give her and her colleagues the right advice.

Jeff Smith: I start by congratulating my friend the hon. Member for Inverclyde (Ronnie Cowan), on securing the debate and on his excellent introduction, and my friend the hon. Member for Reigate (Crispin Blunt), my co-chair of the all-party group for drug policy reform, on his wide-ranging assessment of the various complex issues involved in this difficult problem.
It is unusual to have a debate on the same subject on two successive days. The Minister was in Westminster Hall yesterday when we spoke about the slightly more specific issue of cannabis-based treatments for treatment-resistant epilepsy in children. She will have heard the heart-rending stories, which we have heard many times, of the impact of epilepsy on some of those children and their families, with the fear of hundreds of seizures a day, and the way that it completely takes over families’ lives.
We heard very moving testimony from my hon. Friend the Member for Middlesbrough (Andy McDonald) about the death of his son as a result of epilepsy. That was all very difficult. We also heard about the incredible transformation of lives that can be possible as a result of cannabis-based medical products that treat treatment-resistant epilepsy, and the impact on families. I am talking not just about Alfie and the fact that he is no longer in seizures and that he is able to behave like a normal naughty little boy, as he is described, but about Hannah and her family and the fact that she is able to get back to a normal life. That reflects not just the importance of the impact on families, but the wider savings to the public purse through the reduction in hospital visits and the ability of carers to return to work and become part of society again.
We heard about the frustrations of families unable able to get NHS prescriptions and the costs of private prescriptions. I have a constituent who is not a wealthy man, but he pays about £700 a month for cannabis-based products for his grandson; the family were able to get a private prescription, but not an NHS one. We need to help not only all these vulnerable young people, but their wider families too. As my friend the hon. Member for Reigate said, those people are the tip of the spear and get the publicity, but epilepsy is not the only condition that cannabis-based medical products can help. There is abundant evidence from around the world about the effectiveness of cannabis-based medicines against all kinds of conditions, such as multiple sclerosis, pain, anxiety and nausea. There are tests on Tourette’s and there are lots of other conditions that can be treated with cannabis.
In June 2018, Dame Sally Davies—who was then chief medical officer and chief medical adviser to the Government—was looking at the issue for the Government. She said that there was “conclusive evidence” in support of the use of medical cannabis for a number of conditions and “reasonable evidence” in others. It is safe and effective to prescribe these medicines and patients are being given prescriptions via the private route. As we heard earlier, 10,000 private prescriptions have been  issued in the UK, but we still face a blockage, as a very tiny number of NHS prescriptions have been agreed. It is a great frustration that the public and many Members may feel that this problem has been solved, when it  has not.
I appreciate that there are a number of problems. The Minister has already identified one of them to me: the reluctance of clinicians to prescribe. That is a real problem. The question for us is, how do we give them that comfort to prescribe? There are a couple of ways. The first is evidence, to which I will return in a minute. Another is training. We heard from my friend the hon. Member for Reigate about the difficulty of training clinicians on these issues. The endocannabinoid system—I can never pronounce that word—is a very complex system and it is not part of routine medical training. The 147 different cannabinoids that affect that system are difficult to isolate and the interrelation between them is difficult to identify, but there are people who can provide such training. We need to ensure that it is available to the clinicians, GPs and others who would like to be involved.
Even when a specialist consultant—somebody who is on the register of consultants—has agreed to prescribe, there is another barrier. They have to go to the next level for approval by a higher authority, as I think it is called, which means the trust, the clinical commissioning group or sometimes NHS England, although it is usually the trust. A number of prescriptions have been blocked at that stage, and that is a barrier that private prescribers do not have to surmount, which is a real issue. It seems to be a fault that is built into the system, and I am not convinced that it is a necessary barrier.
We have a set of problems to solve. The Minister knows that I have a private Member’s Bill, the Medical Cannabis (Access) Bill, which is due for debate on 10 December. I hope that it might be an opportunity to address the issue. Somewhat unusually, I guess, I have put that at the disposal of the Government and asked if they will work with me to use this legislative opportunity to find a way forward. I have my own thoughts on how a private Member’s Bill might address the problem and I have made some suggestions that have not yet been supported by Ministers, although in fairness they were supported by the Minister’s predecessor, the hon. Member for Bury St Edmunds (Jo Churchill). I welcome any suggestions or ideas about how we might frame the Bill to get around the problems. Even if we can only make baby steps, I am happy to work with the Government to find a way forward. I really want to make progress, so I make that offer to the Minister again today. I am grateful to her for saying that she will meet me to discuss the issue in the near future.
Let me return to the issue of evidence. As I have said, there is a lot of evidence out there, from around the world, about the effectiveness of cannabis-based products. Lots of work is going on. As the hon. Member for Inverclyde mentioned, the charity Drug Science has a fantastic, academically robust evidence gathering research project called Project Twenty21, in which 1,800 people are currently being treated. I pay tribute to Drug Science. I should declare my interest as a trustee of that charity—an unpaid trustee, of course. The study is an excellent piece of work to try to create a better body of evidence on the issue.
The matter comes down to the medical approvals system in this country, which emphasises so strongly double-blind randomised controlled trials—rightly so, as they are seen as the gold standards of trials. However, that system is set up to look at pharmaceutical products, not at something like whole plant extract medicines. As I mentioned earlier, cannabis contains 147 different cannabinoids, plus terpenoids and various other elements. It is quite a complex interaction on the nervous system. Sometimes a treatment will only work for a particular individual, and individuals have to work out their best balance of treatment.
It is difficult to have randomised controlled trials for such medicines. Leaving aside the moral issue of taking young people who are being treated off their medicine to take a placebo, if it is even possible to get a placebo—from what I hear, I am not convinced that people can really have a placebo for this kind of trial—it is still just a really difficult thing to do. I am not an expert on pharmacology or neurology, but I have spoken to people who are, and some are doubtful that it would be possible to get effective, useful evidence from such randomised controlled trials on whole plant cannabis. It is quite a unique plant that has a unique set of interactions with the body, so it is difficult to carry out those trials effectively.
Randomised controlled trials are not the only method of approval. I am told that 72 drugs have made it on to the approved medicines list without that kind of double-blind controlled study, so there are ways of doing it. The problem is that none of those drugs are plant-based medicines. As I understand it, cannabis is pretty much unique, given the interaction of the elements within it. We need a unique way of looking at the problem and at the evidence.
I made a couple of suggestions to the former Minister about how we might gather evidence and I was knocked back because they might bypass our current system of medical approvals, but I am afraid I have become convinced that part of problem is the current system of medical approvals when it comes to cannabis-based medical products. As my friend the hon. Member for Reigate said, we need Ministers to be flexible and creative, maybe a bit radical—maybe brave, if that is not a word that has been outlawed after its use by Sir Humphrey Appleby. We need Ministers to look at this in a new way. I appreciate that it is really difficult and quite an intractable problem, but we have to look at new ways of breaking the logjam, assessing the evidence base and making it easier for specialists—and perhaps others, such as some GPs—to prescribe.
I appreciate that the Government do not want to give widespread approval for GPs to prescribe these medicines. They are worried about the pressure that GPs might come under from people wanting recreational cannabis; I think that is overstated. Perhaps with some specialist training by an approved body, we might have a register of GPs who are able to prescribe. Most conditions that can be treated by cannabis are what we might call GP conditions—things like pain and anxiety. A survey said that a quarter of GPs would be happy, with the right training, to prescribe medical cannabis. We need to look at how to give people other than specialist consultants on the register a way of prescribing. That is perhaps one  way of tackling this problem. Looking at trying to expand the evidence is so important, because there is so much evidence out there. It may not be through randomised controlled trials, but there are lots of other ways we can gather evidence. There are also a number of ways we can build safeguarding into the system, which I am happy to discuss with the Minister, as that might alleviate some of the concern.
The evidence is all around us that cannabis-based products can help patients. Hundreds of thousands of people in the UK are currently self-medicating. One of my relatives does that to treat their IBS. There are lots of conditions that people use cannabis to alleviate. The problem is that most are buying it illegally. It is probably high-THC skunk that they are getting on the streets, which is not the product that is best suited to them. We need to find a way to enable them to use a safer product. Again, my private Member’s Bill may be part of the solution.
I hope we can find a way forward because, as we heard earlier, this is a problem that ought to have been solved by now and has not been. If we do not have a concerted attack on this issue with some new thinking from Ministers, officials and others, then we are condemning people to continue in a situation where they are paying a fortune for their private product, going to illegal drug dealers, or condemned to pain or ill health from other conditions. We have to find a way forward, and I am very happy to work with the Government to try to do so.

Christine Jardine: It is a pleasure to follow the hon. Member for Manchester, Withington (Jeff Smith). I thank the hon. Member for Inverclyde (Ronnie Cowan) for securing this debate on medicinal cannabis.
I am sure I am not alone in this place in often being asked by people, “What is it that makes you want to be an MP?, “What is it about being an MP that is rewarding?”, or, particularly after days like yesterday, “Is it not frustrating?” When I am asked that, I point them to what happened a couple of years ago, when my constituent Karen Gray came to my office with her wee boy Murray, who, up until that point, had been the subject of lots of conversation and lots of letters back and forward to the Scottish Health Minister and to the then Health Secretary about the availability of cannabis oil. She brought him into the office and he sat and explained to me all about why he liked dinosaurs. That might seem unremarkable. But before then—before he had cannabis oil—Murray was likely to have up to 100 seizures in a day. He had spent much of his life in hospital and missed much of his education, and his parents were worried for his future.
Three years ago, when the then Home Secretary, now Health Secretary, made cannabis oil legal, it gave Murray’s family hope that their lives would change, and their lives have changed, Murray’s life most significantly. But it still is not fixed, because now the specialist who was prescribing cannabis oil for Murray has retired. When they did, earlier this year, they wrote to the Secretary of State asking what was to happen, because there would now be only one clinician in the country prescribing cannabis oil for hundreds of children for whom Epidiolex is not appropriate but for whom cannabis oil does  change their lives and keep them safe. I have spoken to Murray’s mum about this. She is of the opinion—and says that the specialist was as well—that many GPs and doctors in this country want to be able to help their patients with cannabis oil, and that will be possible only if the Department of Health changes its policy and encourages the profession to do so.
This is the third debate on this subject that I have taken part in in the past couple of months. Each of them was secured by an MP from a different party. Today’s debate was secured by the hon. Member for Inverclyde, who is a Scottish National party Member. Yesterday’s debate in Westminster Hall was secured by a Conservative Member. I secured the other debate, as a Liberal Democrat Member, and we had support from Labour Members. I am at a loss as to how an issue that is so emotive, and has so much support across this House and across this country, has to keep coming back. We have to keep asking the same questions. We have to keep saying that clinical trials will not work because cannabis oil is not suitable for clinical trials. Even the NHS has said so. In its report of 8 August 2019, it recommended that there should be alternative trials. By that I assume it means observational trials.
I wonder what motivated the Government and the then Home Secretary to change the law: I suspect that he wanted to do it in the best interests of a child, and children, who were suffering and could be helped by that change in the law. I also wonder how frustrated he, and other politicians who took part in that decision, including all of us who worked hard and campaigned for it, must now be that despite that significant—in some terms, massive—change by this Government, we have not made the intended progress. People are still in pain in this country. Families are spending, as we have heard, upwards of £1,000, sometimes £3,000, a month to secure legal medication for their children that they cannot get on the national health service—the national health service of which we are so proud and that is supposed to deliver free-at-point-of-delivery care from cradle to grave.

Crispin Blunt: A few of us have constituents with a child with epilepsy and have invested the time to get a detailed understanding of many of the issues. The problem, as alluded to by my right hon. Friend the Member for New Forest East (Dr Lewis), is that most of our colleagues think we have done it. After the decision was taken in November 2018—or when the licence was given for Billy Caldwell to get his medicine—the  conclusion was that one would not be able to find anyone who was objecting, because if one can have medicine from the Asian poppy, why on earth can one not have medicine from cannabis? There was probably no opposition in this place at all. But the tragedy is that the evidence is that we have not done it. We must get back into the complexity. We will support the new Minister in fighting her corner to ensure that people can get these medicines, along with all the other interests that are engaged here too.

Christine Jardine: I thank the hon. Member for his intervention. He is absolutely right; I could not agree more. We all thought it was done, but more importantly, and more upsettingly, so did the families of the hundreds of children, and adults, who would benefit—adults with conditions such as multiple sclerosis for whom it  would be life-changing. They all thought it had been done and cannot understand why it is not. I have to be honest: I cannot understand why it is not either, and why it simply cannot be done. Will the Government please consider using observational trials instead of insisting on clinical trials, which are not appropriate?

Daniel Kawczynski: The hon. Lady and I have locked horns on a number of occasions on the radio over the European Union, but I would like her to know that she has support on the Tory Benches, particularly when she talks about children and the conditions they are facing. I hope she will take comfort from the fact that she has support from all political parties in the House in trying to change the legislation on this very important issue.

Christine Jardine: I thank the hon. Member for his comments, and I do take comfort from that, but more importantly, the many hundreds of families watching to see what we do will take comfort from the fact that they have support on the Government Benches as well as the Opposition Benches. I ask the Government and the Minister to take that on board. Will they consider the suggestions that have been made today, as well as using discretionary funding to support those prescriptions that families are currently paying for until we can resolve this issue? Then we can finally achieve what the then Home Secretary and the Government wanted to achieve three years ago when they made cannabis for medical use legal. They did not intend that we would be here now with only three prescriptions issued.

Mary Glindon: It is an honour to follow the hon. Member for Edinburgh West (Christine Jardine). I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing this debate, which, as everyone has said, is yet another debate on the same issue. Three years on from when we had such hope, it is disappointing that we find ourselves still here.
I am going to speak yet again about one of my constituents, a very brave and formidable woman who is known to many in the House, because she has been courageously campaigning for the medical use of cannabis by highlighting the problems she has faced in recent years to access the drug Bedrocan. Lara Smith is a wife and the mother of three children. She was a paediatric nurse and a county fencing coach before her health deteriorated because of cervical and lumbar spondylosis. For over 20 years, she has had 35 different medications, as well as a number of operations for her condition. Unfortunately, she has been left with permanent nerve damage, limited mobility and a constant, annoying and debilitating tremor in her right hand. Her quality of life has been completely impaired. That is not just because of her medical condition, but because of the awful side effects of the drugs she has been prescribed over all those years. This has meant that Lara was not able to be the full-time mother that she wanted to be to her daughters and son.
Fortunately, Lara’s pain management consultant in the north-east prescribed Bedrocan, and the transformation was such that she was able to come off all the other medications. Her young family said that they felt they had their mam back. The downside was that for a time, Lara could access the drug only by travelling to a Dutch  pharmacy to collect it on a private prescription. I have said it before, so I will not go into it again, but she made that arduous journey every three months, bearing in mind the pain she was in. She had to notify full details of her prescription and her travel to Border Force each time. The costs of the medication and travel were very expensive for her family, but they thought that the sacrifice was worthwhile, because of the difference the drug made to Lara.
A couple of years ago, I was successful in raising the issue at Prime Minister’s questions. I received a response from the appropriate Minister at the time, who said that
“there should be no barriers to patients getting access to the appropriately prescribed medicine. The Department of Health and Social Care…has been working closely with suppliers and NHS procurement pharmacists to ensure that prescribed CBPM are available when needed.”
If only that were the case.
Fortunately, Lara no longer has to travel to Holland for her drugs—they are prescribed on a private prescription—but her consultant has unfortunately been unsuccessful in obtaining an individual funding request for her, which is a great disappointment to us all. That is because unfortunately the Northumbria trust—it is a well-respected and well-known trust in many ways, and I always support our trust for a lot of the good things it does, but I am rather frustrated in this instance—followed guidelines that do not advocate the use of cannabinoids, citing a lack of evidence for effective pain relief, because of the difference in the trials put forward to prescribe the drugs, and we have already heard about that issue. On that score, there has been no progress. Perhaps the biggest irony of all is that the trust advocates and allows the prescription of synthetic cannabinoids. For Lara’s drug, a synthetic cannabinoid is £588 a month and unfortunately leaves her quite ill; she pays £100 less for her private prescription. Such a state of affairs seems ludicrous.
There is nothing much I can add to what has been said today. All the speeches are always passionate, and Members speak with such knowledge on the subject—knowledge that has had to be acquired over all the years there has been the fight to win the case. I know that the new Minister, having worked with her on all-party parliamentary groups, is compassionate and knowledgeable, so we put great hope in her that we will see some progress after today’s debate and the other debates that have gone before. I wish her the best of luck in taking this forward, and I am sure she knows we are all behind her. We hope there will be change for the adults and children whose quality of life needs to be improved and can easily be improved if some changes are made in law.

Alyn Smith: It is a great pleasure to close for the Scottish National party in what has been a consensual and informative debate with a great deal of good sense and passion from all parts of the political compass and all points of the House. I warmly congratulate my hon. Friend the Member for Inverclyde (Ronnie Cowan) on securing this important debate.
It is important that we take good note of the reality on the ground. Passing laws and changing regulations are easy for a legislature, but effecting change on the  ground is deeply important for millions of the people who we represent and serve. I have a personal insight to this issue: nine years ago, I was diagnosed with arthritis. It is a family thing. We knew that it was probably in the post. It is well-managed and I am relatively lucky—Versus Arthritis is a great organisation with a lot of good support and advice—but what it has given me is a keen awareness that pain management and chronic medical conditions are life-defining for millions and millions of the people who we serve. Anything that can help alleviate those conditions surely needs to be properly ventilated and worked through for the benefit of those millions of people. Medical cannabis should not be held back by woolly sentiment and outdated thinking. I think there is still a job to be done to move where the state is on that.
I also have a constituency interest, in that in Stirling we host Sapphire Medical Clinics, which is Scotland’s first and so far only medical cannabis prescribing clinic. Since March this year, it has had great success, with upwards of 1,000 referrals of medical cannabis for people across Scotland with chronic pain, anxiety, insomnia and other conditions. That is not to say that medical cannabis is a silver bullet, but it does work for millions of people worldwide, and it deserves to go further. Those 1,000 patients are all part of the UK medical cannabis registry, which has data on 20,000 prescriptions UK-wide, so there is a lot of data being brought through. Sapphire also collaborates closely with the University of the West of Scotland on analysis and research into the efficacy of the treatments. There is a lot of data building, and that is where we need to evolve the thinking of the state in viewing these things.
Obviously I would prefer to see the devolution of drugs policy to the Scottish Parliament. I think we would make a better fist of it than has been made thus far, but there is a challenge to the Minister: let us do it properly and well. Let us make sure that this technology is brought forward. Pending that, there are a number of action points that could be taken, not least in the NHS’s report into the subject, which contains several good points and deserves to be higher up the agenda than it seems to be.
Does the Minister agree that bringing all cannabis prescriptions into the NHS drug dictionary would allow a much better assessment and analysis of the scale of prescription already in existence? There needs to be a change in tone from the Government about drugs policy. We need to view drugs as a health issue through the health prism, rather than the criminal justice prism. If we look at the issue in the right way, we will surely get better answers. I wish the Minister well and I have high hopes that she will agree that that is the way we need to look at it.
Medical cannabis does not work for everybody. It is not a silver bullet, so calls to put things into the NHS system are perhaps premature in some cases, but we need to ventilate that promising technology properly. It could help millions of people. For the people for whom it does work, it works very well, and it could work for an awful lot more. I wish the Minister well in taking it forward. If she does something useful and sensible for the millions of people who are suffering, she will have our support.

Alex Norris: I thank the Backbench Business Committee for granting this important debate and the hon. Members for Inverclyde (Ronnie Cowan), for Edinburgh West (Christine Jardine) and for Reigate (Crispin Blunt) and my hon. Friend the Member for Gower (Tonia Antoniazzi) for securing it. I also thank the cross-party campaigners in this place beyond that group, including the hon. Member for South Leicestershire (Alberto Costa), the right hon. Member for Hemel Hempstead (Sir Mike Penning) and my hon. Friend the Member for Manchester, Withington (Jeff Smith), for all that they have done over the years to put it on the parliamentary agenda.
Progress in making cannabis-based medical products available to those who need them has been slow, so it is right that we have the opportunity to debate the frustrating lack of progress. As hon. Members have said, this is the second debate in two days, which I hope gives those watching confidence that we in this place are taking the issue seriously.
I associate myself with the remarks of the hon. Member for Inverclyde in his opening speech about the families who are dealing with incredible, unthinkable challenges and who handle themselves with such dignity and make such powerful cases. I hope—I feel—that we have done them justice today and will continue to do so. In particular, I hope that the Minister will touch on his points about the limiting factors in research.
The speech of the hon. Member for Reigate was a characteristic tour de force. I always stop to listen when he is talking about the issue, because he speaks with such power. He made the point that it is unacceptably cruel to take effective medicines away from a child, which we all agree with. He linked that to palliative care, and I share the view that we want people at the end of their life to get whatever treatment might make their final days the best that they can be. Actually, that applies to adults throughout their lives: if people are living in pain and do not have to be, I would want to do anything I could to avert that.
The hon. Gentleman spoke about the 2018 regulations and the sense that we thought they had solved it, as the right hon. Member for New Forest East (Dr Lewis) also said. The hon. Member for Reigate gave us a hopeful way forward by concluding that we need to be creative and solution-focused. The Opposition share that view—I do not think there is a lot of politics on this issue—and support coming together to find a practical, effective, safe and risk-aware solution.
My hon. Friend the Member for Manchester, Withington spoke in that spirit. He is fortunate to have been drawn in the private Member’s Bill ballot, which is precious for any right hon. or hon. Member. He is keen to work with the Government. I know him well and know the spirit in which he will work with them, so I hope the Minister will take that up. That private Member’s Bill would be a perfect vehicle to move the issue forward. His point that it is about not just epilepsy was well made. I double underlined the phrase that we need to give clinicians the “comfort to prescribe”, which was elegantly put. I completely support that goal and will come back to it.
The hon. Member for Edinburgh West spoke about her constituency case of Murray. Many right hon. and hon. Members will recognise similar cases in their surgeries. The daftness of that story is that the UK’s prescribing  could grind to a halt on the basis of a single person retiring. Where else in the health service would that ever be the case or tolerated? It is an absurd set of affairs.
My hon. Friend the Member for North Tyneside (Mary Glindon) kindly facilitated the opportunity for me to meet her constituent, who is a doughty campaigner, as she says. To hear the impact on her constituent’s life, it is hard to understand why we are not doing everything we can to make sure that she can live with as little pain as possible. I will get on to the counterargument about the lack of evidence, but she is that evidence, because we know what her life was like before and after, so I find that argument hard to accept.
The common theme of the contributions has been frustration or, more positively, a desire to redouble our efforts in this area, which cuts both ways. There are opportunities in research, which I hope the Minister will talk about, with regards to epilepsy, long-term pain relief and mental health. We also need a stronger position on the regulation of products such as cannabidiol, which proliferate on the internet and can be found in various shops, in all sorts of forms, promising all sorts of things that are hard to establish. We need better regulation in that space.
When the Government accepted the therapeutic use of cannabis, it was met, as we have heard, with much relief from campaigners, such as the families of Billy Caldwell and Alfie Dingley, who has now gone 508 days without an epileptic fit thanks to his medicinal cannabis treatment. It has changed his life, but not everyone has been so lucky.
Bailey Williams has been denied access to medicinal cannabis for his epilepsy and his parents are forced to raise £1,200 a month for his treatment. The mother of 11-year-old Teagan Appleby spends about £2,000 a month to treat her daughter’s Lennox-Gastaut syndrome, as she has not received a prescription. In the time that she has been taking that treatment, she has to go to hospital only once—when it ran out. That is the impact on her life.
I think of my constituents and how few, if any, could spare £2,000 a month. Of course, all of them, and I daresay all of us, would go to whatever lengths necessary for our children—that is the tragic paradox—but it is not acceptable. We are letting people down on an issue that we thought we had resolved.
In 2018, cannabis-based products were rescheduled. Guidelines were produced by the National Institute for Health and Care Excellence and three products got through: Epidyolex for rare forms of epilepsy, Nabiximols for multiple sclerosis-related spasticity and Nabilone for side effects from chemotherapy. The regulations said that initial prescriptions must be made by a specialist medical practitioner and, in all cases, would be considered only when other treatments were unsuitable or had not worked.

Lisa Cameron: The hon. Gentleman is making an excellent point. Does he agree that the psychological pressure and stress of having to campaign constantly and raise money at that level is simply unfair? My constituent Lisa Quarrell has had to raise thousands of pounds for her child Cole Thomson and has been under that stress continually for years. It is time for us to work collectively to overcome any hurdles to achieving success.

Alex Norris: I have seen the fundraisers online, as other hon. Members will have. When people have to raise that amount of money each month, they must not be able to do anything else and they must live with that anxiety constantly. We want to relieve people of that as far as we can.
We know that the number getting through has been dreadfully low. The previous Minister said in February that 413 unique eligible patients had been identified, but no estimate had been made of the number who had received prescriptions. End Our Pain believes that only three prescriptions have been issued on the NHS—goodness me, that is not what we thought it would be three years ago. If the Minister has more up-to-date information, we would be keen to hear it, but there is definitely a sense that it is not going anywhere near far enough.
Last year, a Care Quality Commission report found that a meagre 6.5% of cannabis-based items were prescribed on the NHS. Again, that is a paradox because we are told that there is real anxiety about prescribing it, but if people pop it into a search engine, they can find an awful lot of private treatments that do not seem anxious at all—there seem to be fewer shy bairns there. I am not sure that that is quite the defence that those who use it think it is.
It is a matter of justice if people are missing out or are left with the horrendous choice between paying over the odds for medication and suffering. The founding principle—the settled political point—of the national health service is that we do not tolerate that or think that people’s access should be based on their ability to pay, but we are tolerating that here, so I hope we can do better.

Julian Lewis: I have been looking at the Hansard of yesterday’s debate—there is an opportunity for the Minister to refer to it when she makes her remarks—and I see that one of the main points she made yesterday was the fact that there is insufficient evidence on the safety aspects and the possible harm effects. Given that families are paying all this money and finding other ways of getting the cannabis-based products, would it be a way forward if families were asked to sign a waiver if it were prescribed, so that the people doing the prescribing would be protected against any subsequent action if in fact something went wrong? It might be for the family to take that decision on the balance of benefit and harm.

Alex Norris: I am grateful for that intervention. I am slightly torn in the sense that I have absolutely no doubt that families would take it on that basis, but as a former trade union official, I would never have advised a member to sign away their rights. I think that is what we are getting at when the hon. Member for Reigate says that we have to come up with something creative that means we can clear this hurdle, and that is one such option.
Let me link that back to a previous intervention by the right hon. Member for New Forest East on opiates—if you will briefly indulge a thought experiment, Mr Deputy Speaker. If the reverse were true and we routinely prescribed cannabis-based products to deal with pain issues, would anybody really be advocating at the Dispatch Box that we should instead swap them for opiates and that they would be a better alternative? I think the answer to that is an obvious one, and that should be guiding our thinking.

Ronnie Cowan: A vital point was made there about who should be prescribing this. Dr Martinez, the retiring private prescriber of medical cannabis, has written to the Secretary of State for Health and, on the group she prescribes for, she said:
“I know that a majority of the GPs dealing with this group of children wish to prescribe, but, in order to do so, this requires a change of policy from the Health Department because it is CBD medication which has been treated differently to other controlled drugs.”
The solution is there. I get the point that parents can agree to a waiver, but they should not have to. This can be changed, and the Secretary of State for Health has been asked to do this by a consultant.

Alex Norris: That is very handy timing from the hon. Gentleman because I was just about to make that point. Following that retirement, Robin Emerson, the father of Jorja Emerson—he is behind the Jorja Foundation and has been campaigning tirelessly—has written to the Secretary of State and the Prime Minister asking them to intervene, but my understanding is that he is yet to receive a reply. I hope the Minister will commit to that being immediately addressed because this is very important indeed.
I will make a couple of final points before I finish. I listened very carefully to what the Minister said in the debate yesterday—we are in a novel position of having them on consecutive days, which is helpful—and it is clear that the Minister considers it a clinician issue rather than a political one, but that is not working at the moment. We are in a strange situation of there being so much concern about the nebulous long-term effects of these prescriptions that that is seen as better than, say, leaving a child fitting 100 times or more a day. It is rather like not throwing a rope to a drowning person for fear of their burning their hands on it. I find that hard to imagine, but we are in such a  situation.
I fear that merely putting this at the door of clinicians is defending the status quo. I feel that we in this place do have agency and, indeed, a responsibility to act. I hope to hear from the Minister that there is going to be a greater drive from the Department to encourage clinicians. My hon. Friend the Member for Manchester, Withington offered suggestions on the training that I know is out there, and again I am keen to hear what we can do to have that picked up more reasonably.
Across this debate and the debate yesterday, clear themes have emerged: better research, or perhaps creative research, as the hon. Member for Edinburgh West said; better engagement with clinicians, again with the points my hon. Friend the Member for Manchester, Withington made; and, for goodness’ sake, immediate relief for families in the system now. They are going through things we would never tolerate for ourselves or would absolutely hate for ourselves, and I feel we that have a real responsibility to step that up.
I think there is broad consensus on this, and we now need to come together on a flexible solution to do it. Just as the SNP spokesman, the hon. Member for Stirling (Alyn Smith), said, we will support the Government if they bring that forward. This is something I think we all share, and the families are watching us and waiting for us to do it.

Maria Caulfield: I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on bringing forward this debate. As has been said, this is the second day in a row that we are debating this important issue, and I appreciate the depth of feeling on it. I know there are many Members who wished to speak today but who have not been able to, including the hon. Member for Gower (Tonia Antoniazzi) and my hon. Friends the Members for Dover (Mrs Elphicke)—Teagan Appleby is her constituent—and for South Derbyshire (Mrs Wheeler).
As I said yesterday, I have huge sympathy for the issues, problems and struggles that patients and their families are facing. They are trying desperately to access these drugs. No one wants a resolution to this more than me and the Secretary of State, who, as has had been said a number of times, changed the law when he was Home Secretary to try to resolve this situation.
Yesterday, I confirmed the Government’s absolute commitment to take an evidence-based approach to unlicensed cannabis-based products for medicinal use in order to ensure that there is evidence that they are effective but also safe. A number of colleagues have asked why the Government cannot accept non-randomised controlled trials as evidence. The Government are not involved in the process of licensing the medicines; that is done by the independent regulator. The Government’s responsibility is in changing the law, which has already been done, but I very much take the point that we should be able to influence the speed at which the licensing process can take place. I will point out in my remarks how we are doing that.
I am willing to work with colleagues across the House, whether that is the hon. Member for Manchester, Withington (Jeff Smith), with his private Member’s Bill, or SNP Members. This is a non-political issue that we want to see resolved, but the Government are not the body responsible for licensing medication or assessing the worthiness of the research, whether that is randomised controlled trials or any other form of evidence.
Before I set out what is being done, I want to provide an update on the matter of Bedrocan, because the hon. Member for North Tyneside (Mary Glindon), my hon. Friend the Member for Reigate (Crispin Blunt) and the hon. Member for Inverclyde all mentioned it. The commercial agreement between Transvaal Apotheek and UK specialist medicines manufacturer Target Healthcare is progressing, and the MHRA and the Home Office are working with those companies to ensure that all regulatory standards for manufacturing these medicines are met.
On 16 September, the Home Office granted a six-month licence, which will allow Target to move on to testing its equipment and procedures using cannabis from the Netherlands and validating their production of Bedrocan oils. Departmental officials continue to work closely with the Dutch Government, Transvaal, the Home Office and the MHRA to ensure continuity of supply until domestic production can be established, and I will keep the House updated on progress. I hope that is a little glimmer of hope on that issue.
I am aware that there is huge patient demand for access to medical cannabis, and that many are convinced it is helping them with an array of medical conditions   from chronic pain to cancer. To date, however, much of the evidence suggesting cannabis could be effective as a treatment is anecdotal. While that has some strength in observational studies, from the regulator’s point of view it often needs more robust clinical data.
There are two licensed cannabis-based products and one synthetic cannabinoid that mimics the effects of THC, which is the element I think most campaigners are looking for. We do have Sativex to treat severe spasticity in adults with multiple sclerosis, Epidyolex for the treatment of two rare forms of epilepsy and Nabilone for nausea and vomiting, so we are making some progress. I hear from campaigners that the THC element remains outstanding. Those products that are licensed are proof that when manufacturers invest in clinical trials, the potential of cannabis as a medicine can be realised. Clinical trials generate the data needed by our world-leading medicines regulator, the Medicines and Healthcare products Regulatory Agency, to assess for safety, and it is then for NICE to approve the NHS funding element of that.
Let me reiterate that this is a multiple-step process. Orkambi has been mentioned; the issue with that was not licensing—it had a licence—but NHS funding. If we get to the licensing stage, the Government can do a huge amount more to fast-track things and be involved in discussions. Licensing, however, is an independent process, and that is the point at which we are stuck.

Crispin Blunt: I used that parallel as an example. I totally respect my hon. Friend’s point about licensing progress—of course she is correct—but this is about thinking imaginatively to work our way through the problems to the right solution. That applies desperately in this situation, as it did with Orkambi.

Maria Caulfield: Absolutely. The Government are committed to trying to resolve the blockage to licensing, which is the main factor hindering the prescription of these drugs. The Health and Social Care Secretary changed the law when he was Home Secretary, but that was not the end of the issue, and that is why we are taking these next steps. It is important not to dismiss the importance of licensed medication. We know from history that when medication that may have a good clinical effect is not tested thoroughly, there can be grave consequences, just as with thalidomide. The safety of a medicine is as important as its efficacy. I am not casting aspersions on cannabis, but the regulator has responsibility for all medicines, and it takes that issue very seriously.

Julian Lewis: That argument would surely carry more weight if the people doing the testing outlined some sort of timeline and plan for concluding a testing programme, rather than apparently letting things drift on aimlessly for years on end.

Maria Caulfield: I take my right hon. Friend’s point. I will come on to that, and to timelines for the research that is in progress. Many of the products that we are talking about have not been licensed by any licensing authority across the world, including the Food and Drug Administration, the European Medicines Agency and our domestic MHRA. This is not just a UK problem; it is not the UK Government who are holding this back.
As I said yesterday, I encourage manufacturers of these products to invest in clinical trials. Part of the Department’s work is providing funding for the National Institute for Health Research, which is actively opening its arms to charities, academics, researchers, manufacturers and third-sector organisations. Funding is available for clinical trials, if anyone wants to come forward with one, be it a randomised control trial, an observational study, a randomised control trial without a placebo arm, or a phase 1, 2 or 3 clinical study. The MHRA is willing to provide advice and support to any potential applicants who want to conduct a clinical trial or seek a licence for their medicines. There is funding and support; we need researchers to come forward with clinical trials.

Ronnie Cowan: A lot of research institutes are restricted in what they can do because they are trying to access a category 2 product. If it was category 4, life would be a lot simpler for them.

Maria Caulfield: The hon. Gentleman makes an excellent point, and going forward we perhaps need to unblock some of the blockages in that area. I take that point on board.
Clinical trials and the licensing process provide evidence and information that doctors rely on to support their treatment decisions. Many clinicians have fed back that they are reticent to prescribe these products until there is more evidence, because ultimately they are responsible for their patients when it comes to a treatment’s safety and effectiveness. Doctors are particularly unwilling, given the THC element of cannabis products; there is some emerging data and evidence of harm, particularly to children, including effects on the developing brain and heart. That is why the evidence base is so crucial, but I am happy—I say this especially to the hon. Member for Manchester, Withington, who sponsors the Medical Cannabis (Access) Bill—to consider what blockages could be unblocked to speed that process up.
Doctors are right to be cautious when prescribing any product if they are not confident in the evidence base. As I said yesterday, I am clear that prescription remains a clinical decision, as does prescription of any medication. It would be inappropriate for the Government to force clinicians to prescribe a medicine, but we will try to unblock some of the licensing blockages.
Let me highlight some of the studies that are starting to take off. This might have been mentioned, but from 1 April we have the establishment of clinical trials for NHS England and the NIHR. We have introduced a national patient registry, which will record patient outcomes, with a view to its being rolled out across the devolved Administrations. It is England-only at the moment. We are aiming to record the data of those who receive the medicines, and to consider side-effects, efficacy and a whole range of issues, in order to support clinicians working with patients, and to start to build an evidence base.
In addition, a randomised control trial is being set up. It has three arms, which will include one arm with CBD or THC, and one arm with a placebo. We expect it to open fairly soon. Those looking to access these drugs—children in particular—will be able to do so in a  blinded way and can take part in the study. If the data come through relatively quickly, that will open up opportunities to submit evidence to the MHRA.

Ronnie Cowan: Who would offer a child who is on medication that stops them having 100 seizures a day a random test that potentially contains a placebo?

Maria Caulfield: I take the hon. Gentleman’s point, but many children are not accessing this medication, and this is a route to that. As I explained in yesterday’s debate, clinical randomised control trials with a placebo arm have extremely strict rules, and if one arm of the study is showing incredible progress and doing better than the other arms, the study must be stopped, patients unblinded, and everyone switched to the arm that is doing the best. In some circumstances, that has enabled people to access drugs under clinical research in a much quicker way. It does have some advantages.

Christine Jardine: That is all very well, but it brings us back to the fact that there are children who are already benefiting from the drugs. Even the NHS has asked whether it would not be beneficial to have an alternative trial, such as an observational one, and to use that evidence, rather than having a clinical trial with all these pitfalls.

Maria Caulfield: I take the hon. Lady’s point, but the MHRA, which is the regulator, and other regulators around the world have a tier of research that they will accept. The randomised controlled trial method is the gold standard, and the more randomised controlled data someone has, the more likely they are to get a trial approved quickly. Of course observational studies will be used. That is why, if researchers have a large group, want to do observational studies—we heard about the Sapphire clinic from the hon. Member for Inverclyde—and come forward with observational data, I encourage them to speak to the MHRA to see whether that is the sort of research that would be acceptable. It is important that they have those discussions with the regulating body, because it may well accept some of that evidence.
Until manufacturers, researchers, academics and those using these drugs in practice come forward with whatever research they feel would be acceptable and have those discussions, we will go round in a circle. I am keen that if observational studies are acceptable, we support them to happen. Whatever it takes, in research terms, to get a licence through, the Government are there, providing funding, advice and support. However, ultimately, they are not the body that can make that decision; but I think there is a willingness around the House to try to find a resolution.
It will take time to generate further evidence and see the results of clinical trials. The Health Secretary and I are committed to doing everything in our power to accelerate this work. There have been some helpful suggestions this afternoon that we may need to go away and look at.
I thank everyone again. Although this is the second debate on this subject in two days, I know that it will not be the last; the private Member’s Bill will come forward next month. I want to put on the record my commitment to this issue. It is extremely difficult. In yesterday’s debate, we heard constituents’ stories relayed by their MPs, including the hon. Member for Middlesbrough  (Andy McDonald). They really are very moving testaments, and we want to find a way forward. We have changed the law, but that has clearly not been enough. We need to find a resolution, so that we can get these medications licensed if the clinical evidence is there, and we need to work with the regulator.

Lisa Cameron: I know that the Minister is committed to this issue. Could the Government perhaps appoint a lead clinician for this issue, to give clinicians across the United Kingdom confidence, and to drive the issue forward at pace, so that we see movement in the short term?

Maria Caulfield: The hon. Lady makes a good point. If there are clinicians who want to take a lead on this, there is obviously scope to look at that, but we must be clear that we have to license and support research for this medicine in the way we would any other. I have given a commitment today to working with hon. Members on both sides of the House to demonstrate how seriously the Government take this issue.

Ronnie Cowan: I thank everyone who attended the debate and spoke. I want to pull the Minister back to one thing that I asked about. Will she please look at the most recent information from the BPNA? If I am  interpreting that correctly, it will make prescribing more difficult. I hope I am wrong, but she has far more medical experience than I have.
We developed a covid vaccine in under a year, and rolled it out across the country to massive numbers of people, and it was free to those who needed it. I ask that we bring the same sense of urgency to this debate. To all the parents and others watching the debate—I know they are watching, because they have been texting me since I sat down an hour and a half ago; many of the questions I put to the Minister came from parents from around the United Kingdom—I say: thank you for driving this campaign forward. I hope that it does not end here, and that the fight goes on—hopefully in an amicable fashion. I hope we can all do better for all of you.
Question put and agreed to.
Resolved,
That this House has considered the matter of the use of medical cannabis for the alleviation of health conditions.

Adjournment

Resolved, That this House do now adjourn.—(Gareth Johnson.)
House adjourned.